title: Medical therapy of heart failure with reduced ejection fraction: current evidence and new developments.
abstract: Heart failure with reduced ejection fraction (HFrEF) is a common cardiovascular condition with a significant individual and societal burden. Although it was previously known as a palliative condition, medical drug therapies that were developed in the last four decades significantly reduced morbidity and mortality of the disease. The cornerstone of HFrEF therapy remains the blockade of the renin-angiotensin-aldosterone and the β-adrenergic systems. This review aims to give an overview and update on established disease-modifying therapies in HFrEF, discuss advances and setbacks in the treatment of selected comorbidities and provide an outlook on upcoming therapies including the new concept of dual angiotensin receptor and neprilysin inhibition.
authors.affiliation: University Heart Centre, Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Naegele
authors.affiliation: University Heart Centre, Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Flammer
authors.affiliation: University Heart Centre, Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Enseleit
authors.affiliation: University Heart Centre, Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Ruschitzka
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D000077550:Ivabradine; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D015260:Neprilysin / Q000037:antagonists & inhibitors; D013318:Stroke Volume; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D002316:Cardiotonic Agents; D002317:Cardiovascular Agents; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D014665:Vasodilator Agents; D006830:Hydralazine; D000077550:Ivabradine; D004077:Digoxin; D015260:Neprilysin; D007548:Isosorbide Dinitrate