Abstract
Heart failure with reduced ejection fraction is a significant driver of morbidity
and mortality. There are common misconceptions regarding the disease processes underlying
heart failure and best practices for therapy. The terms heart failure with reduced
ejection fraction and left ventricular systolic dysfunction are not interchangeable
terms. Key therapies for heart failure with reduced ejection fraction target the underlying
disease processes, not the left ventricular ejection fraction alone. The absence of
congestion does not rule out heart failure. Patients with cardiac amyloidosis can
also present with heart failure with reduced ejection fraction. A rise in serum creatinine
in acute heart failure exacerbation is not associated with tubular injury. Guideline
directed medical therapy should be continued during acute exacerbations of heart failure
with reduced ejection fraction and should be started in the same hospitalization in
new diagnoses. Marginal blood pressure is not a relative contraindication to optimal
guideline directed medical therapy. Guideline directed medical therapy should be continued
even if ejection fraction improves. There are other therapies that provide significant
benefit besides the four key medications in guideline directed medical therapy.
Keywords
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Article info
Publication history
Published online: February 03, 2023
Accepted:
January 11,
2023
Received:
December 27,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
