ABC Heart Fail Cardiomyop 2022; 2(1): 15-23
Treatment of Heart Failure with reduced Ejection Fraction in 2022: The Essential Pillars
Marcely Gimenes Bonatto
, Andressa de Oliveira Coiradas, Lídia Ana Zytynski Moura
Abstract
Pharmacological treatment of heart failure with reduced ejection fraction (HFREF) has undergone changes over the years as discoveries have been made related to new systems involved in its pathophysiology and, consequently, of new therapeutic targets. For this treatment, certain drug classes have become essential and should be used in combinations with the objective of reducing the disease’s high rates of morbidity and mortality. They are therefore considered the pillars of treatment for patients with HFREF. These drug classes act on the renin-angiotensin-aldosterone system (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists), on the autonomic nervous system (beta blockers), on the natriuretic peptides system (neprilysin and angiotensin receptor inhibitors), and on the sodium-glucose cotransporter 2 (sodium-glucose cotransporter 2 inhibitors). 1 This article will present an analytical summary of the pathophysiologic foundations and the scientific evidence that demonstrates the benefit of these medications, specifically in terms of their impact on the results of clinical trials.
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