ARTICLE IN PRESS +Model Rev Clin Esp. 2020;xxx(xx):xxx---xxx www.elsevier.es/rce Revista Clínica Española ORIGINAL ARTICLE Management of patients with heart failure treated in cardiology consultations: IC-BERG Study  V. Barrios a,∗ , C. Escobar b , C. Ortiz Cortés c , J. Cosín Sales d , D.A. Pascual Figal e , X. García-Moll Marimón f a Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain b Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain c Servicio de Cardiología, Hospital San Pedro de Alcántara, Cáceres, Spain d Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain e Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain f Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Received 4 September 2019; accepted 31 October 2019 KEYWORDS Heart failure; Stable heart failure; Natriuretic peptides; Cardiology; Primary care. Abstract Objective: To determine the perception and management of heart failure with reduced ejection fraction (HFrEF) by clinical cardiologists and to establish a consensus with recommendations. Methods: We employed the modified Delphi method among a panel of 150 experts who answered a questionnaire that included 3 blocks: definition and perception of patients with ‘‘stable’’ HFrEF (15 statements), management of patients with ‘‘stable’’ HFrEF (51 statements) and recommendations for optimising the management and follow-up (9 statements). The level of agreement was assessed with a Likert 9-point scale. Results: A consensus of agreement was reached on 49 statements, a consensus of disagreement was reached on 16, and 10 statements remained undetermined. There was consensus regarding the definition of ‘‘stable’’ HF (82%), that HFrEF had a silent nature that could increase the mortality risk for mildly symptomatic patients (96%) and that the drug treatment should be optimised, regardless of whether a patient with HFrEF remains stable in the same functional class (98.7%). In contrast, there was a consensus of disagreement regarding the notion that treatment with an angiotensin receptor-neprilysin inhibitor is justified only when the functional class worsens (90.7%). Conclusions: Our current understanding of ‘‘stable’’ HF is insufficient, and the treatment needs to be optimised, even for apparently stable patients, to decrease the risk of disease progression. © 2020 The Author(s). Published by Elsevier Espa˜ na, S.L.U. All rights reserved.  Please cite this article as: Barrios V., Escobar C., Ortiz Cortés C., Cosín Sales J., Pascual Figal D.A., García-Moll Marimón X. Manejo de los pacientes con insuficiencia cardiaca atendidos en la consulta de cardiología: Estudio IC-BERG. Rev Clin Esp. 2020. https://doi.org/10.1016/j.rce.2019.10.011 ∗ Corresponding author. E-mail address: vivenciobarrios@gmail.com (V. Barrios). 2254-8874/© 2020 The Author(s). Published by Elsevier Espa˜ na, S.L.U. All rights reserved. RCENG-1786; No. of Pages 10