title: Heart Failure Due to Reduced Ejection Fraction: Medical Management.
abstract: Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, direct-acting vasodilators, beta blockers, and aldosterone antagonists. Additionally, some data show benefits from two new classes of drugs: angiotensin receptor blocker/neprilysin inhibitor and sinus node modulator. Diuretics and digoxin can be used as needed for symptom control. Statins are not recommended solely for treatment of heart failure. Implantable cardioverter-defibrillators and biventricular pacemakers improve mortality and function in selected patients. For patients who have been hospitalized for heart failure, disease management programs and telemonitoring can reduce hospitalizations and mortality.
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Chavey
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Robrt V
authors.initials: RV
authors.lastname: Hogikyan
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: R
authors.initials: R
authors.lastname: Van Harrison
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Nicklas
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000553:Ambulatory Care / Q000379:methods*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002304:Cardiac Pacing, Artificial; D019317:Evidence-Based Medicine; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists