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Treatment of Heart Failure with Abnormal Left Ventricular Systolic Function in Older Adults

Wilbert S Aronow1

  • 1Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Macy Pavilion, Room 141, Valhalla, NY 10595, USA.

Heart Failure Clinics
|June 13, 2017
PubMed

Insights

Identify and treat heart failure (HF) with abnormal left ventricular (LV) ejection fraction. Key treatments include ACE inhibitors, beta-blockers, and diuretics, with specific options like sacubitril/valsartan and isosorbide dinitrate/hydralazine for certain populations.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart failure (HF) with reduced ejection fraction requires timely identification and management.
  • Effective treatment strategies are crucial for improving patient outcomes and quality of life.

Purpose of the Study:

  • To outline current evidence-based treatment recommendations for heart failure with abnormal left ventricular ejection fraction.
  • To discuss the role of various pharmacological agents and device therapies in managing HF.

Main Methods:

  • Review of current clinical guidelines and landmark studies on heart failure management.
  • Analysis of treatment protocols for hypertension, myocardial ischemia, and volume overload in HF patients.
  • Evaluation of specific therapies including ACE inhibitors, beta-blockers, diuretics, sacubitril/valsartan, and isosorbide dinitrate/hydralazine.

Main Results:

  • Diuretics, ACE inhibitors, and beta-blockers are foundational treatments for HF.
  • Sacubitril/valsartan offers an alternative to ACE inhibitors or ARBs in specific HF cases.
  • Isosorbide dinitrate/hydralazine is recommended for African Americans with advanced HF.
  • Exercise training is a recommended component of HF management.

Conclusions:

  • Comprehensive management of HF involves addressing comorbidities like hypertension and ischemia.
  • Pharmacological interventions should be tailored to patient characteristics and HF severity.
  • Advanced therapies, including device implantation, play a role in selected HF patients.

Keywords:
Aldosterone antagonistsAngiotensin-converting enzyme inhibitorsBeta blockersDigoxinHeart failureMyocardial infarctionNitratesPositive inotropic drugs

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