title: A practical guide for the treatment of symptomatic heart failure with reduced ejection fraction (HFrEF).
abstract: This review will outline the management of patients with symptomatic systolic heart failure or heart failure with reduced ejection fraction (HFrEF), i.e., those with structural heart disease and previous or current symptoms. Determination of volume status and appropriate diuretic administration is important in heart failure management. Inhibition of the renin-angiotensin-aldosterone and sympathetic nervous systems improves survival and decreases hospitalizations in patients with systolic or reduced ejection fraction HF (HFrEF). Beta blockers and aldosterone antagonists improve ejection fraction. Indications for additional agents including nitrates plus hydralazine, digoxin, statins, omega 3 polyunsaturated fatty acids, anticoagulants, and antiarrhythmics will be discussed. Choice of agents, dose-related effects, strategies to minimize adverse effects, and medications to avoid will be presented.
authors.forename: Brent N
authors.initials: BN
authors.lastname: Reed
authors.affiliation: University of North Carolina, 160 Dental Circle, CB 7075, Chapel Hill, NC 27599-7075, USA. carla_sueta@med.unc.edu.
authors.forename: Carla A
authors.initials: CA
authors.lastname: Sueta
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D018479:Early Intervention, Educational; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors