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Updated: Oct 19, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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The 'diamond' approach to personalized drug treatment of heart failure with reduced ejection fraction

Hongbo Gan1, Heng Tang1, Yujie Huang2

  • 1Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China.

Reviews in Cardiovascular Medicine
|September 26, 2021
PubMed

Insights

New heart failure (HF) therapies like SGLT2 inhibitors and ARNIs offer improved outcomes for heart failure with reduced ejection fraction (HFrEF). This review proposes an early, comprehensive "HF diamond approach" for optimal treatment timing and combination strategies.

Area of Science:

  • Cardiology and Cardiovascular Medicine
  • Pharmacology and Therapeutics
  • Clinical Medicine

Background:

  • Heart failure (HF) is a significant clinical syndrome characterized by cardiac dysfunction, leading to substantial hospitalization and morbidity.
  • While conventional neurohormonal blockade therapies improve prognosis in heart failure with reduced ejection fraction (HFrEF), mortality and rehospitalization rates remain high.
  • Emerging therapies including ivabradine, angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter 2 (SGLT2) inhibitors, vericiguat, and omecamtiv mecarbil (OM) show promise for HFrEF management.

Purpose of the Study:

  • To systematically review the optimal application of novel HFrEF therapies under various clinical conditions.
  • To provide evidence-based suggestions on clinical use timing, application scope, and combination strategies for these advanced treatments.
  • To introduce and advocate for the "HF diamond approach" for early and comprehensive intervention in HFrEF.

Main Methods:

  • Systematic review of current knowledge on novel HFrEF therapies.
  • Analysis of clinical data and previous studies on ivabradine, ARNI, SGLT2 inhibitors, vericiguat, and omecamtiv mecarbil.
  • Development of the "HF diamond approach" as a novel therapeutic strategy.

Main Results:

  • Novel therapies demonstrate significant benefits in managing HFrEF.
  • Optimal timing and combination of therapies are crucial for maximizing patient outcomes.
  • The proposed "HF diamond approach" emphasizes early and comprehensive treatment initiation.

Conclusions:

  • The "HF diamond approach" offers a new paradigm for HFrEF management, distinct from current guidelines.
  • Early and comprehensive application of novel therapies, guided by the diamond approach, can prevent further HF deterioration.
  • This strategy aims to maximize the prognosis for patients with HFrEF by optimizing treatment strategies from the outset of ventricular remodeling.

Keywords:
Diamond approachHeart failureIndividualized treatmentNew therapies

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