Key result
Inhibition of the renin-angiotensin-aldosterone and sympathetic nervous systems improves survival and decreases hospitalizations in patients with symptomatic heart failure with reduced ejection fraction.
This review outlines the pharmacological management of symptomatic HFrEF, highlighting therapies that improve survival, decrease hospitalizations, and improve ejection fraction.
Affirms neurohormonal blockade in symptomatic HFrEF; supports guidelines yet leaves sequencing with novel agents open.
This review will outline the management of patients with symptomatic systolic heart failure or heart failure with reduced ejection fraction (HFrEF), i.e., those with structural heart disease and previous or current symptoms. Determination of volume status and appropriate diuretic administration is important in heart failure management. Inhibition of the renin-angiotensin-aldosterone and sympathetic nervous systems improves survival and decreases hospitalizations in patients with systolic or reduced ejection fraction HF (HFrEF). Beta blockers and aldosterone antagonists improve ejection fraction. Indications for additional agents including nitrates plus hydralazine, digoxin, statins, omega 3 polyunsaturated fatty acids, anticoagulants, and antiarrhythmics will be discussed. Choice of agents, dose-related effects, strategies to minimize adverse effects, and medications to avoid will be presented.
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Reed et al. (2014) conducted a review in Symptomatic heart failure with reduced ejection fraction (HFrEF). Heart failure medications (diuretics, RAAS inhibitors, beta blockers, aldosterone antagonists) was evaluated. Inhibition of the renin-angiotensin-aldosterone and sympathetic nervous systems improves survival and decreases hospitalizations in patients with symptomatic heart failure with reduced ejection fraction.
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