Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5619578 | Progress in Cardiovascular Diseases | 2017 | 34 Pages |
Abstract
Despite the great progress made in the management of heart failure (HF) with reduced ejection fraction (HFrEF), its prevalence continues to rise owing to an aging population and an epidemic of hypertension, obesity and coronary artery disease. For decades, angiotensin converting enzyme inhibitors and beta blockers have been the mainstay of HFrEF therapy. The recent addition of sacubitril/valsartan and ivabradine to the HF armamentarium has the potential to transform our therapeutic approach to HFrEF, while simultaneously raising some questions and uncertainties on their applicability. In this paper, we review the pathophysiology of HFrEF, discuss already established and novel evidenced-based pharmacologic therapies available for these patients. We also share some therapeutic strategies aimed to optimize HF therapy in specific undertreated patient populations including the elderly and patients with chronic kidney disease, while offering insight on how to tailor therapy in the “real-world.”
Keywords
GDMTRAASCNPBNPSNSRCTLVEFACCFHFrEFNYHALCZ696ARNiFDACardiac Insufficiency Bisoprolol StudyHFSAMERIT-HFSOLVDVal-HeFTARBANPAHACORQOLNSRQuality of lifeRandomized controlled trialAngiotensin converting enzyme inhibitorsConsensusCHARMAmerican Heart AssociationNew York Heart AssociationUnited Statesleft ventricle or left ventricularchronic kidney diseaseShiftguideline-directed medical therapyguideline directed medical therapyDoseRadianceNormal sinus rhythmralesFood and Drug AdministrationSeniorsLevel of evidenceRenin-angiotensin-aldosterone systemsympathetic nervous systembeats per minuteOutcomesBlood pressurecardiovascularLoEManagementBMPBeta blockersAngiotensin receptor blockerStudies of Left Ventricular DysfunctionRandomized Aldactone Evaluation StudyACEI یا angiotensin convert enzyme inhibitorheart failureheart failure with reduced ejection fractionCKDbrain natriuretic peptideatrial natriuretic peptidenatriuretic peptidesPioneerAmerican College of Cardiology Foundationleft ventricular ejection fractionClass of RecommendationCopernicus
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Authors
J. Barr Biglane, Miriam F. Becnel, Hector O. Ventura, Selim R. Krim,