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Heart Failure with Reduced Ejection Fraction

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Handbook of Outpatient Cardiology

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Abstract

Heart failure is a rising epidemic characterized by dyspnea or exercise intolerance due to impaired ventricular filling, ejection of blood, or a combination of both. There have been several developments in the past decade pertaining to medical and device therapies for patients with heart failure and a reduced ejection fraction. There are now four pillars of pharmacologic therapy to improve outcomes for patients with heart failure and a reduced ejection fraction. These are angiotensin receptor-neprilysin inhibitors, β-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors. Important device therapies include implantable cardiac defibrillators, cardiac resynchronization therapy, transcatheter mitral valve repair, and wireless pulmonary artery pressure monitors. In this chapter we discuss the approach to diagnosing and managing heart failure with reduced ejection fraction, with a particular focus on these important pharmacological and device therapies.

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Abbreviations

ACE:

Angiotensin-converting enzyme

ARB:

Angiotensin II receptor

ARNI:

Angiotensin receptor-neprilysin inhibitors

BNP:

B-type natriuretic peptide

CRT:

Cardiac resynchronization therapy

eGFR:

Estimated glomerular filtration rate

FDG-PET:

Fluorodeoxyglucose-positron emission tomography

GDMT:

Guideline-directed medical therapy

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

ICD:

Implantable cardiac defibrillator

MRA:

Mineralocorticoid receptor antagonist

NT-proBNP:

N-terminal pro-B-type natriuretic peptide

NYHA:

New York Heart Association

RAAS:

Renin-angiotensin-aldosterone system

SGLT2:

Sodium-glucose cotransporter 2

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Prashant Rao & Marwa A. Sabe

Authors
  1. Prashant Rao
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  2. Marwa A. Sabe
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Corresponding author

Correspondence to Marwa A. Sabe .

Editor information

Editors and Affiliations

  1. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Ankit A. Bhargava

  2. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Bryan J. Wells

  3. Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Pablo A. Quintero

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Rao, P., Sabe, M.A. (2022). Heart Failure with Reduced Ejection Fraction. In: Bhargava, A.A., Wells, B.J., Quintero, P.A. (eds) Handbook of Outpatient Cardiology . Springer, Cham. https://doi.org/10.1007/978-3-030-88953-1_15

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  • DOI: https://doi.org/10.1007/978-3-030-88953-1_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-88952-4

  • Online ISBN: 978-3-030-88953-1

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