Pharmacologic Therapy for Heart Failure With Reduced Ejection Fraction: Closing the Gap Between Clinical Guidelines and Practice

被引：15

作者：

Biglane, J. Barr ^{[1
,2
]}

Becnel, Miriam F. ^{[1
,2
]}

Ventura, Hector O. ^{[1
,2
,3
]}

Krim, Selim R. ^{[1
,2
,3
]}

机构：

[1] John Ochsner Heart & Vasc Inst, Div Cardiol, New Orleans, LA USA

[2] Ochsner Clin Fdn, John Ochsner Heart & Vasc Inst, Sect Cardiomyopathy & Heart Transplantat, 1514 Jefferson Highway, New Orleans, LA 70121 USA

[3] Univ Queensland, Sch Med, Ochsner Clin Sch, New Orleans, LA USA

来源：

PROGRESS IN CARDIOVASCULAR DISEASES | 2017年 / 60卷 / 02期

关键词：

Heart failure with reduced ejection fraction; Guideline directed medical therapy; Management; Outcomes; RANDOMIZED-TRIAL; ELDERLY-PATIENTS; SYSTOLIC DYSFUNCTION; ISOSORBIDE DINITRATE; INHIBITOR THERAPY; MORTALITY; CARVEDILOL; ENALAPRIL; DIGOXIN; INSUFFICIENCY;

D O I：

10.1016/j.pcad.2017.08.006

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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." (C) 2017 Elsevier Inc. All rights reserved.

引用

页码：187 / 197

页数：11

共 45 条

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