Congestive heart failure pharmacotherapy

2026-05-10T17:14:19Z

Overview

← Older revision		Revision as of 17:14, 10 May 2026
Line 4:		Line 4:

	== Overview ==		== Overview ==
			Management of heart failure is guided by [[ejection fraction]] phenotype ([[HFrEF]] vs HFmrEF/[[HFpEF]]), clinical stage, congestion status, and underlying etiology, with the goals of improving symptoms, reducing hospitalization, and improving survival. Contemporary care prioritizes rapid initiation and optimization of GDMT (foundational 4-drug therapy in [[HFrEF]]; SGLT2 inhibitor–centered, comorbidity-driven therapy with selective ARNI/[[ARB]]/MRA in HFmrEF/[[HFpEF]]) alongside diuretics for relief of congestion. Longitudinal management requires structured reassessment of symptoms, vitals, renal function/electrolytes, and cardiac function to guide titration, add-on therapies, and candidacy for [[Implantable cardioverter defibrillator\|ICD]]/[[Cardiac resynchronization therapy\|CRT]] or structural interventions, with referral for advanced HF therapies when progression occurs. Effective implementation is strengthened by multidisciplinary HF programs, patient education and lifestyle interventions, and coordinated transitions of care.

	== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==		== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==

Congestive heart failure with preserved EF pharmacotherapy

2026-05-10T16:38:28Z

← Older revision		Revision as of 16:38, 10 May 2026
(2 intermediate revisions by the same user not shown)
Line 49:		Line 49:
	\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction		\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>		❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LemonChiffon; width: 70%" align=left\|
	❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
	❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
Line 64:		Line 64:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


Line 89:		Line 89:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==		==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==
Line 113:		Line 113:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
Line 169:		Line 169:
	{{familytree/end}}		{{familytree/end}}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}


Line 184:		Line 184:

	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ Screening, treatment, investigation of underlying etiologies, and		❑ Screening, treatment, investigation of underlying etiologies, and
	[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>		[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>
Line 192:		Line 192:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


Line 243:		Line 243:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==External Link==		==External Link==

Congestive heart failure chronic pharmacotherapy

2026-05-10T16:24:34Z

Show changes

Congestive heart failure pharmacotherapy

2026-05-10T06:57:07Z

Show changes

wikidoc - Changes related to "Congestive heart failure left ventricular assist devices" [en]

Congestive heart failure pharmacotherapy

Congestive heart failure with preserved EF pharmacotherapy

Congestive heart failure chronic pharmacotherapy

Congestive heart failure pharmacotherapy