Key result
Pharmacologic therapy with ACE inhibitors, ARBs, and vasodilators interrupts the neurohormonal cascade to impact morbidity and mortality in heart failure with reduced ejection fraction.
This review article summarizes the mechanism of action, clinical trial evidence, and practical application of ACE inhibitors, ARBs, and vasodilators in the management of heart failure with reduced ejection fraction.
Pharmacologic treatment for systolic heart failure, otherwise known as heart failure with reduced ejection fraction, has been established through clinical trials and is formulated into guidelines to standardize the diagnosis and treatment. The premise of pharmacologic therapy in heart failure with reduced ejection fraction is aimed primarily at interrupting the neurohormonal cascade that is responsible for altering left ventricular shape and function. This is the first in a series of articles to describe the pharmacologic agents in the guidelines that impact the morbidity and mortality associated with heart failure. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and vasodilators will be presented in the context of the mechanism of action in heart failure, investigational trials that showed beneficial effects, and the practical application for clinical use.
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Paul et al. (2015) conducted a review in Heart failure with reduced ejection fraction. Pharmacotherapy (ACE inhibitors, ARBs, and vasodilators) was evaluated. Pharmacologic therapy with ACE inhibitors, ARBs, and vasodilators interrupts the neurohormonal cascade to impact morbidity and mortality in heart failure with reduced ejection fraction.
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