Contemporary management of Heart Failure with Reduced Ejection Fraction: Current challenges and future perspectives
Heart failure (HF) is a common clinical syndrome associated with a mortality rate that varies with the severity of disease and can be modified by the administration of appropriate medical and device therapy. HF with reduced ejection fraction (with LVEF ≤40 percent, HFrEF) is associated with unacceptably high rates of morbidity, mortality and hospital readmissions despite advances in treatment of acute coronary syndrome and approval of novel medical and device therapies. Recent studies suggest that the benefit of a comprehensive "quadruple" regimen including an angiotensin receptor-neprilysin inhibitor, a sodium-glucose cotransporter 2 inhibitor), a mineralocorticoid receptor antagonist and a beta-blocker is substantially greater than previously used simpler regimens. The care of patients with HFrEF is complicated and on top of medical and device therapies includes management of the cause of HF and associated conditions, monitoring, preventative care, care coordination, education and support for HF self-management cardiac rehabilitation, and palliative care. However, a major challenge in the management of HFrEF is the accurate identification of those patients who have a poor prognosis and who would therefore be most likely to benefit from intensive medical therapy and/or cardiac transplantation.
HFrEF has an increasing incidence, prevalence, readmission rates and high cost of care. Recent advances in the field are gradually incorporated into daily practice and their impact on patient outcomes and health-care utilization remains to be seen. In light of the recent advances and the existing challenges in the management of patients with HFrEF, we introduce this series of concise reviews that will focus on the contemporary management of these patients and explore the multiple aspects of their care.
We would like to invite experts in the field of HFrEF to write comprehensive reviews (3000 to 5000 words) covering the following topics:
-Contemporary pharmacologic therapies for Heart Failure with Reduced Ejection Fraction
-Management of arrhythmias, conduction system diseases and risk of sudden cardiac death in Heart Failure with Reduced Ejection Fraction
-Pulmonary Hypertension in Left Sided Heart Disease
-Chronic disease management in Heart Failure with Reduced Ejection Fraction: Focus on remote monitoring and telemedicine
-Contemporary management of patients with end-stage Heart Failure: current challenges and future perspectives.
Asst. Prof. Alexandros Briasoulis
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