Heart failure with reduced ejection fraction (HFrEF)
- Start 4 disease-modifying pillars early
- ARNI/ACEi/ARB
- evidence-based beta blocker
- MRA + SGLT2 inhibitor
- Titrate in parallel, not serially
- Loop diuretic treats congestion, not survival
- Ivabradine/vericiguat for selected residual risk
Use at a glance
- Start 4 disease-modifying pillars early
- ARNI/ACEi/ARB
- evidence-based beta blocker
- MRA + SGLT2 inhibitor
Practical pearls
- Titrate in parallel, not serially
Other practical pearls
- Loop diuretic treats congestion, not survival
Choosing treatment
- Ivabradine/vericiguat for selected residual risk
Self-check
- What are the 4 early disease-modifying pillars in HFrEF?
ARNI/ACEi/ARB, beta blocker, MRA, and SGLT2 inhibitor.
Drugs used for this (11)
All clinical uses · Open the interactive console ↗
