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Reflecting On The Advancements Of Hfref Therapies Over The Last Two Decades And Predicting What Is Yet To Come, Iliana L. Piña, Gregory T. Gibson, Shelley Zieroth, Rachna Kataria

Division of Cardiology Faculty Papers

What was once considered a topic best avoided, managing heart failure with reduced ejection fraction (HFrEF) has become the focus of many drug and device therapies. While the four pillars of guideline-directed medical therapies have successfully reduced heart failure hospitalizations, and some have even impacted cardiovascular mortality in randomized controlled trials (RCTs), patient-reported outcomes have emerged as important endpoints that merit greater emphasis in future studies. The prospect of an oral inotrope seems more probable now as targets for drug therapies have moved from neurohormonal modulation to intracellular mechanisms and direct cardiac myosin stimulation. While we have come a long …