Management of Heart Failure with Reduced Ejection Fraction (HFrEF) Based on Current International Guidelines

Abstract

Heart failure (HF) is a clinical syndrome that consists of cardinal symptoms and the accompanying signs. HF poses a significant health and economic burden as it affects approximately 38 million people worldwide. Pharmacological therapies that target the renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system, and neurohormones have been developed to reduce mortality and morbidity in patients with heart failure reduced ejection fraction (HFrEF).

The triad of angiotensin-converting enzyme inhibitors (ACE-i) or an angiotensin receptor-neprilysin inhibitor (ARNI), beta-blockers, and mineralocorticoid receptor antagonists (MRA) has been proven to improve survival, reduce the risk of rehospitalizations, and reduce symptoms in patients with HFrEF. In the latest international guidelines both European and American, sodium-glucose cotransporter 2 (SGLT2) inhibitors, dapagliflozin and empagliflozin, has just been included as standard therapy for patients with HFrEF with class I recommendation.