Proper therapeutic management of patients with heart failure (HF) is a major challenge for cardiologists. Current guidelines indicate to start therapy with angiotensin converting enzyme inhibitors/angiotensin receptor neprilysin inhibitors (ACEi/ARNI), beta blockers (BB), mineralocorticoid receptor antagonists (MRAs) and sodium glucose cotransporter 2 inhibitors (SGLT2i) to reduce the risk of death and hospitalization due to HF. However, certain aspects still need to be defined. Current guidelines propose therapeutic algorithms based on left ventricular ejection fraction values and clinical presentations. However, these last do not always reflect the precise hemodynamic status of patients and pathophysiological mechanisms involved, particularly in the acute setting. Even in the field of chronic management there are still some critical points to discuss. The guidelines do not specify which of the four pillar drugs to start first, nor at what dosage. Some authors suggest starting with SGLT2i and BB, others with ACEi or ARNI, while one of the most recent approach proposes to start with all four drugs together at low doses. The aim of this review is to revise current gaps and perspectives regarding pharmacological therapy management in HF patients, in both the acute and chronic phase.

Heart failure pharmacological management. gaps and current perspectives / Severino, Paolo; D'Amato, Andrea; Prosperi, Silvia; Myftari, Vincenzo; Sofia Canuti, Elena; Labbro Francia, Aurora; Cestiè, Claudia; Maestrini, Viviana; Lavalle, Carlo; Badagliacca, Roberto; Mancone, Massimo; Vizza, Carmine Dario; Fedele, Francesco. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:3(2023). [10.3390/jcm12031020]

Heart failure pharmacological management. gaps and current perspectives

Paolo Severino
Primo
;
Andrea D’Amato;Silvia Prosperi;Vincenzo Myftari;VIVIANA MAESTRINI;Carlo Lavalle;ROBERTO BADAGLIACCA;Massimo Mancone;Carmine Dario Vizza;Francesco Fedele
2023

Abstract

Proper therapeutic management of patients with heart failure (HF) is a major challenge for cardiologists. Current guidelines indicate to start therapy with angiotensin converting enzyme inhibitors/angiotensin receptor neprilysin inhibitors (ACEi/ARNI), beta blockers (BB), mineralocorticoid receptor antagonists (MRAs) and sodium glucose cotransporter 2 inhibitors (SGLT2i) to reduce the risk of death and hospitalization due to HF. However, certain aspects still need to be defined. Current guidelines propose therapeutic algorithms based on left ventricular ejection fraction values and clinical presentations. However, these last do not always reflect the precise hemodynamic status of patients and pathophysiological mechanisms involved, particularly in the acute setting. Even in the field of chronic management there are still some critical points to discuss. The guidelines do not specify which of the four pillar drugs to start first, nor at what dosage. Some authors suggest starting with SGLT2i and BB, others with ACEi or ARNI, while one of the most recent approach proposes to start with all four drugs together at low doses. The aim of this review is to revise current gaps and perspectives regarding pharmacological therapy management in HF patients, in both the acute and chronic phase.
2023
acute heart failure; chronic heart failure; heart failure; left ventricular ejection fraction; management; therapy
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Heart failure pharmacological management. gaps and current perspectives / Severino, Paolo; D'Amato, Andrea; Prosperi, Silvia; Myftari, Vincenzo; Sofia Canuti, Elena; Labbro Francia, Aurora; Cestiè, Claudia; Maestrini, Viviana; Lavalle, Carlo; Badagliacca, Roberto; Mancone, Massimo; Vizza, Carmine Dario; Fedele, Francesco. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:3(2023). [10.3390/jcm12031020]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1669265
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