Key result
Advances in medical therapy, such as neprilysin inhibition, and mechanical support offer patients with advanced heart failure with reduced ejection fraction improvement in both survival and quality of life.
Why the study?
Despite treatment, the prognosis for advanced HFrEF remains poor, while advances in medical therapy and mechanical support offer improvements in survival and quality of life.
This review highlights the evolving landscape of advanced HFrEF management, including newer medical therapies, mechanical support devices, and updated transplant allocation criteria, underscoring the critical need for timely specialist referral.
May inform specialist referral in advanced HFrEF; leaves open prospective validation of survival and quality-of-life gains.
Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades. However, with treatment, the prognosis for patients with advanced HFrEF remains poor. Fortunately, advances in medical therapy and mechanical support offer some patients improvement in both survival and quality of life. We review advances in short- and long-term mechanical support and explore changes to organ allocation for cardiac transplantation. In addition, we provide a guide to facilitate appropriate referral to an advanced heart failure team.
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Hicks et al. (2020) conducted a review in Advanced heart failure with reduced ejection fraction (HFrEF). Advanced heart failure therapies (medical therapy, ECMO, LVAD, transplantation) was evaluated. Advances in medical therapy, such as neprilysin inhibition, and mechanical support offer patients with advanced heart failure with reduced ejection fraction improvement in both survival and quality of life.
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