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Review
. 2023 Mar 9;10(3):114.
doi: 10.3390/jcdd10030114.

Practical Pharmacological Treatment of Heart Failure: Does Ejection Fraction Matter Anymore?

Jonathan C H Chan  1   2 , Emily Cowley  3 , Michael Chan  2
Affiliations
Review

Practical Pharmacological Treatment of Heart Failure: Does Ejection Fraction Matter Anymore?

Jonathan C H Chan et al. J Cardiovasc Dev Dis. .

Abstract

Heart failure (HF) is a complex clinical syndrome involving structural and/or functional abnormalities of the heart. Heart failure is often classified based on left ventricular ejection fraction, which serves as a predictor of mortality. The majority of the data supporting disease-modifying pharmacological therapies are from patients with reduced ejection fraction (less than 40%). However, with the recent results from the sodium glucose cotransporter-2 inhibitor trials, there is renewed interest in identifying potential beneficial pharmacological therapies. This review focuses on and includes pharmacological HF therapies across the spectrum of ejection fraction, providing an overview of the novel trials. We also examined the effects of the treatments on mortality, hospitalization, functional status, and biomarker levels to further investigate the interplay between ejection fraction and HF.

Keywords: SGLT2i; beta blocker; cardiovascular disease; dilated cardiomyopathy; ejection fraction; heart failure; ivabradine; spironolactone.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Foundational heart failure therapy consisting of Sodium Glucose Cotransporter 2 Inhibitors (SGLT2i), mineralocorticoid receptor antagonists (MRA), angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), angiotensin receptor-neprilysin inhibitors (ARNI), beta blockers and ivabradine and their respective ejection fraction spectrums.
See this image and copyright information in PMC

References

    1. Bozkurt B., Coats A.J.S., Tsutsui H., Abdelhamid C.M., Adamopoulos S., Albert N., Anker S.D., Atherton J., Böhm M., Butler J., et al. Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. Eur. J. Heart Fail. 2021;23:352–380. doi: 10.1002/ejhf.2115. - DOI - PubMed
    1. Berei T. Universal Definition and Classification of Heart Failure. American College of Clinical Pharmacy; Lenexa, Kansas: 2022.
    1. McDonald M., Virani S., Chan M., Ducharme A., Ezekowitz J.A., Giannetti N., Heckman G.A., Howlett J.G., Koshman S.L., Lepage S., et al. CCS/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure with Reduced Ejection Fraction. Can. J. Cardiol. 2021;37:531–546. doi: 10.1016/j.cjca.2021.01.017. - DOI - PubMed
    1. Hajar R. Congestive Heart Failure: A History. Heart Views. 2019;20:129–132. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_77_19. - DOI - PMC - PubMed
    1. Consensus Trial Study Group Effects of Enalapril on Mortality in Severe Congestive Heart Failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS) N. Engl. J. Med. 1987;316:1429–1435. doi: 10.1056/NEJM198706043162301. - DOI - PubMed