Article Dans Une Revue European Journal of Heart Failure Année : 2025

Clinical management and therapeutic optimization of patients with heart failure with reduced ejection fraction and low blood pressure. A clinical consensus statement of the Heart Failure Association (HFA ) of the ESC

1 UOB - University of Balamand [Liban]
2 Sheikh Shakhbout Medical City [Abu-Dhabi]
3 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
4 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
5 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
6 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
7 BHF GCRC - British Heart Foundation Glasgow Cardiovascular Research Centre
8 Universität des Saarlandes [Saarbrücken] = Saarland University [Saarbrücken]
9 UKS - Saarland University Hospital
10 ASST Spedali Civili di Brescia - Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia]
11 UniBs - Università degli Studi di Brescia = University of Brescia
12 ZOL - Ziekenhuis Oost-Limburg
13 UHasselt - Hasselt University
14 Karolinska Institutet = Karolinska Institute [Stockholm]
15 DEÜ - Dokuz Eylül Üniversitesi = Dokuz Eylül University [Izmir]
16 HUJ - The Hebrew University of Jerusalem
17 GTPUH - Germans Trias i Pujol University Hospital [Badalona, Barcelona, Spain]
18 BCM - Baylor College of Medicine
19 Baylor Scott and White Research Institute [Dallas, TX, USA]
20 UMMC - University of Mississippi Medical Center
21 UMPCD - University of Medicine and Pharmacy “Carol Davila”
22 Hôpital Lariboisière-Fernand-Widal [APHP]
23 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
24 UAM - Universidad Autónoma de Madrid
25 La Paz University Hospital
26 Hospital das Forcas Armadas [Porto, Portugal]
27 FMUP - Faculdade de Medicina da Universidade do Porto
28 Wrocław Medical University
29 University of Belgrade [Belgrade]
30 St George's, University of London
31 IRCCS San Raffaele [Rome, Italy]
32 San Raffaele Open University of Rome
33 San Raffaele Cassino Hospital
Piotr Ponikowski
Petar Seferovic

Résumé

Despite major advancements in heart failure (HF) management and guideline recommendations over the past two decades, real‐world evidence highlights suboptimal implementation of guideline‐directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF). Low blood pressure (BP) is common in HFrEF patients and represents a major perceived barrier to implementing life‐saving treatments in clinical practice, as physicians are often concerned about symptomatic hypotension and its consequences. Although low BP can be seen in those hospitalized with signs of shock, the most common scenario involves non‐severe, asymptomatic hypotension in patients receiving foundational therapy for HFrEF, where premature down‐titration or discontinuation of GDMT should be avoided. This clinical consensus statement provides a comprehensive overview of low BP in HFrEF, including its definition, risk factors, and effects of HF therapies on BP. We propose management pathways to optimize HFrEF treatment in the context of low BP, ultimately aiming to improve patient outcomes.

Fichier principal
Vignette du fichier
Manuscript.pdf (1.63 Mo) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Licence

Dates et versions

hal-04997552 , version 1 (19-03-2025)

Licence

Identifiants

Citer

Hadi Skouri, Nicolas Girerd, Luca Monzo, Mark C. Petrie, Michael Böhm, et al.. Clinical management and therapeutic optimization of patients with heart failure with reduced ejection fraction and low blood pressure. A clinical consensus statement of the Heart Failure Association (HFA ) of the ESC. European Journal of Heart Failure, 2025, 27 (4), pp.707-722. ⟨10.1002/ejhf.3618⟩. ⟨hal-04997552⟩
149 Consultations
61 Téléchargements

Altmetric

Partager

  • More