New perspectives in the treatment of chronic heart failure

Area of Science:

• Cardiology
• Pharmacology

Background:

• The European Society of Cardiology (ESC) updated heart failure guidelines in 2021, categorizing patients based on left ventricular ejection fraction (reduced, mildly reduced, preserved).
• Current guidelines incorporate recent evidence-based medicine and clinical study findings.

Purpose of the Study:

• To summarize the key recommendations from the 2021 ESC heart failure guidelines.
• To highlight the role of novel pharmacotherapies, specifically SGLT2 inhibitors (gliflozins), in managing heart failure.
• To emphasize the importance of managing comorbidities and adopting a multidisciplinary approach.

Main Methods:

• Review of the 2021 European Society of Cardiology (ESC) heart failure guidelines.
• Analysis of evidence supporting the use of SGLT2 inhibitors (gliflozins) in heart failure management.
• Inclusion of recommendations for treating comorbidities and implementing integrated care models.

Main Results:

• Heart failure patients are classified into reduced, mildly reduced, and preserved ejection fraction groups.
• SGLT2 inhibitors (gliflozins) are identified as a novel drug class to reduce morbidity and mortality in patients with reduced ejection fraction.
• American College of Cardiology guidelines recommend gliflozin treatment irrespective of ejection fraction.
• Management strategies emphasize treating comorbidities such as diabetes, iron deficiency, and tumors.

Conclusions:

• The 2021 ESC guidelines provide a contemporary framework for heart failure management based on ejection fraction.
• SGLT2 inhibitors (gliflozins) represent a significant advancement in pharmacotherapy for heart failure, particularly with reduced ejection fraction.
• A comprehensive management strategy, including addressing comorbidities and utilizing heart failure clinics, is crucial for optimal patient care.