Management of heart failure with reduced ejection fraction

Figure 1. NICE guideline for the treatment of suspected heart failure. Reproduced under the NICE UK Open Content licence. NT-proBNP, N-terminal component of B-type natriuretic peptide.

Figure 2. Hyperenhancement (HE) patterns following administration of gadolinium contrast at MRI according to aetiology of left ventricular systolic dysfunction. Reprinted with permission from Shah.34 HTN, hypertension.

Figure 3. ESC 2021 Therapeutic algorithm of Class I Therapy Indications for a patient with heart failure with reduced ejection fraction. Reproduced from McDonagh et al.7 ACE-I = angiotensin-converting enzyme inhibitor; ARNI = angiotensin receptor-neprilysin inhibitor; CRT-D =cardiac resynchronization therapy with defibrillator; CRT-P = cardiac resynchronization therapy pacemaker; ICD = implantable cardioverter-defibrillator; HFrEF = heart failure with reduced ejection fraction; MRA = mineralocorticoid receptor antagonist; QRS = Q, R, and S waves of an ECG; SR = sinus rhythm. aAs a replacement for ACE-I. bWhere appropriate. Class I = green. Class IIa = Yellow.

Figure 4. Overview of homeostatic mechanisms in HFREF. BNP, B-type natriuretic peptide; HFrEF, heart failure with reduced ejection fraction.

Figure 5. UK NICE decision grid regarding device therapy in individuals with HFrEF according to NYHA class and QRS duration. Reproduced with the NICE UK Open Content licence. CRT, cardiac resynchronisation therapy; CRT-D, cardiac resynchronisation therapy defibrillator; ICD, implanted cardioverter defibrillator; CRT-P, cardiac resynchronisation therapy pacemaker; NICE, National Institute for Health and Care Excellence.