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Where are we in 2021 with heart failure with reduced ejection fraction?-current outlook and expectations from new
Agnieszka Dębska-Kozłowska1, Marcin Książczyk2, Małgorzata Lelonek3
1Military Medical Academy Memorial Teaching Hospital, Central Veteran Hospital, Medical University of Lodz, Lodz, Poland.
Insights
Optimal medical therapy for heart failure with reduced ejection fraction (HFrEF) shows poor prognosis. This review summarizes novel molecules and proposes an individualized treatment approach for HFrEF patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Guideline-directed optimal medical therapy is standard for heart failure with reduced ejection fraction (HFrEF).
- Despite treatment, HFrEF patients face poor prognosis and high mortality.
- Recent trials investigate new therapies considering population heterogeneity.
Purpose of the Study:
- To summarize recent findings on novel molecules for HFrEF treatment.
- To propose a revolutionary, individualized approach to HFrEF pharmacotherapy.
- To address challenges in determining target doses for HFrEF medications.
Main Methods:
- Review of recently published trial results on novel HFrEF therapies.
- Analysis of pharmacotherapy challenges, including target dose determination.
- Exploration of new drug formulations for faster therapeutic effects.
Main Results:
- Emerging novel molecules show promise in HFrEF management.
- New drug formulations may simplify treatment and accelerate therapeutic effects.
- Individualized dosing strategies are crucial for optimizing HFrEF therapy.
Conclusions:
- Current HFrEF treatment strategies require optimization.
- Novel molecules and individualized approaches offer potential for improved HFrEF patient outcomes.
- Further research is needed to refine personalized pharmacotherapy for HFrEF.
Abstract:
Guideline-directed optimal medical therapy is a well-established therapy in treating patients with heart failure with reduced ejection fraction (HFrEF). Despite clear recommendations, the prognosis in this group of patients is still poor with high mortality. After publishing results of the PARADIGM-HF trial (Prospective Comparison of ARNI-Angiotensin Receptor/Neprilysin Inhibitors-with ACEI-Angiotensin-Converting Enzyme Inhibitor-to Determine Impact on Global Mortality and Morbidity in Heart Failure) clinical investigators accelerated their research. Recently, many new trials have been designed to evaluate the efficacy and safety of promising management, taking into account heterogeneity of population with chronic HFrEF. Determining target doses still poses the biggest problem in standard pharmacotherapy. Implementation of new substances for the HFrEF therapy makes it possible to formulate simple rules of treatment-in most cases, administering a dose of drug in one tablet provides a faster therapeutic effect. The aim of this article is to summarize current knowledge on recently announced findings on novel molecules and to propose a new revolutionary and individualised approach to treatment of HFrEF patients.
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