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A Novel Approach to Medical Management of Heart Failure With Reduced Ejection Fraction by Robert J.H. Miller; Jonathan G. Howlett; Nowell M. Fine is a Medicine article available to read on EtoBox.

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The advent of newly available medical therapies for heart failure with reduced ejection fraction (HFrEF) has resulted in many potential therapeutic combinations, increasing treatment complexity. Publication of expert consensus guidelines and initiatives aimed to improve implementation of treatment has emphasized sequential stepwise initiation and titration of medical therapy, which is labour intensive. Data taken from heart failure registries show suboptimal use of medications, prolonged titration times, and consequently little change in dose intensity, all of which indicate therapeutic inertia. Recently published evidence indicates that 4 medication classes-renin-angiotensin-neprilysin inhibitors, β-blockers, mineralocorticoid antagonists, and sodium-glucose cotransporter inhibitors-which we refer to as Foundational Therapy, confer rapid and robust reduction in both morbidity and mortality in most patients with HFrEF and that they work in additive fashion. Additional morbidity and mortality may be observed following addition of several personalized therapies in specific subgroups of patients. In this review, we discuss mechanisms of action of these therapies and propose a framewor

Who reads A Novel Approach to Medical Management of Heart Failure With Reduced Ejection Fraction?

Author

Robert J.H. Miller; Jonathan G. Howlett; Nowell M. Fine

Publisher

Elsevier BV

Published

2021

Language

EN

Field

Medicine (Health Sciences)