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©2013 UpToDate ® Print Email ACC/AHA/ESC guideline summary: Management of patients with heart failure (HF) and preserved systolic function Class I - There is evidence and/or general agreement that the following approaches are effective in the management of HF and preserved left ventricular systolic function • Control of hypertension, both systolic and diastolic, according to current guidelines. • Control of ventricular rate in atrial fibrillation. • Control of pulmonary congestion and peripheral edema with diuretics. Class IIa - The weight of evidence or opinion is in favor of the usefulness of the following approach in the management of HF and preserved left ventricular systolic function • Coronary revascularization for symptomatic or asymptomatic myocardial ischemia that is thought to have an adverse effect of cardiac function. Class IIb - The weight of evidence or opinion is less well established for the usefulness of the following approaches in the management of HF and preserved left ventricular systolic function • Restoration of sinus rhythm to improve diagnosis in patients with atrial fibrillation. • Among patients controlled hypertension, use of beta blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers in an attempt to reduce symptoms of HF. • Digitalis to reduce symptoms of HF. Data from: Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005; 112:e154.