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Background: Several surveys show that patients with chronic heart failure (CHF) are sub-optimally managed and treatment guidelines are not implemented in clinical practice. Aims: To investigate awareness and perceptions of the 2005 European Society of Cardiology (ESC) guidelines for CHF. Methods: 467 cardiologists from seven European countries completed an on-line interview using a validated, semi-structured questionnaire including questions about awareness and relevance of CHF guidelines. To assess agreement with ESC guidelines, three fictitious patient cases were presented and respondents' management choices compared with those of an expert panel based on the guidelines. Results: Awareness of CHF guidelines was high, with 98% aware of any guideline and 65% aware of ESC guidelines. ESC guidelines were considered relevant (51%) or very relevant (38%) for guiding treatment decisions. Up to 92% of respondents perceived that they adhered to the ESC guidelines. For the patient cases, ≤ 25% made treatment recommendations that completely matched those formulated by the expert panel. Respondents considered patient compliance (52%) and guideline complexity (46%) major barriers to implementation. Conclusion: Cardiologists reported high awareness of and a positive attitude towards ESC CHF guidelines. Provision of guidelines in a concise and accessible format is perceived as a key factor to improve implementation. © 2008 Elsevier B.V. All rights reserved.

Original publication




Journal article


European Journal of Heart Failure

Publication Date





1020 - 1025