Optimisation of treatments for heart failure with reduced ejection fraction in routine practice: a position statement from a panel of experts - Université de Lorraine Access content directly
Journal Articles Revista Española de Cardiología (English version) Year : 2023

Optimisation of treatments for heart failure with reduced ejection fraction in routine practice: a position statement from a panel of experts

Optimización de los tratamientos de la insuficiencia cardiaca con fracción de eyección reducida en la práctica diaria: propuesta de un grupo de expertos

Abstract

Major international practice guidelines recommend the use of a combination of 4 medication classes in the treatment of patients with heart failure with reduced ejection fraction (HFrEF) but do not specify how these treatments should be introduced and up-titrated. Consequently, many patients with HFrEF do not receive an optimized treatment regimen. This review proposes a pragmatic algorithm for treatment optimization designed to be easily applied in routine practice. The first goal is to ensure that all 4 recommended medication classes are initiated as early as possible to establish effective therapy, even at a low dose. This is considered preferable to starting fewer medications at a maximum dose. The second goal is to ensure that the intervals between the introduction of different medications and between different titration steps are as short as possible to ensure patient safety. Specific proposals are made for older patients (> 75 years) who are frail, and for those with cardiac rhythm disorders. Application of this algorithm should allow an optimal treatment protocol to be achieved within 2-months in most patients, which should the treatment goal in HFrEF.
Fichier principal
Vignette du fichier
36914024.pdf (1.13 Mo) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-04029734 , version 1 (15-03-2023)

Identifiers

Cite

Nicolas Girerd, Christophe Leclercq, Olivier Hanon, Antoni Bayés-Genís, James L Januzzi, et al.. Optimisation of treatments for heart failure with reduced ejection fraction in routine practice: a position statement from a panel of experts. Revista Española de Cardiología (English version), 2023, 76 (10), pp.813-820. ⟨10.1016/j.rec.2023.03.005⟩. ⟨hal-04029734⟩
889 View
528 Download

Altmetric

Share

Gmail Facebook X LinkedIn More