Heart Failure (Part 2)

The treatment for heart failure (HF) caused by systolic dysfunction (heart failure with reduced ejection fraction, HFREF) is currently better defined than that of HF caused by diastolic dysfunction (heart failure with preserved ejection fraction, HFPEF). Available drugs include blockers of the renin-angiotensin-aldosterone system (i.e. angiotensin-converting enzyme inhibitors, angiotensin II AT-1 receptor blockers, aldosterone antagonists, direct renin inhibitors), beta blockers, diuretics, nitrate derivatives and digoxin. When HF stage III-IV with left ventricular ejection fraction less than 35% and QRS complexes greater 120 ms persist despite optimal medical therapy, cardiac resynchronization therapy (CRT) yields a benefit in the majority of cases, both in terms of quality of life and reduction in mortality.