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Latest Standard Management for Heart Failure with Guideline-Directed Medical Therapy (GDMT)
1Tokushima University / Medical Research, Tokushima, Japan
2Integrative Medicine Japan (IMJ), Shikoku Island division, Tokushima, Japan
Corresponding Author: Hiroshi BANDO, MD, PhD, FACP ORCID iD
Address: Tokushima University /Medical Research, Nakashowa 1-61, Tokushima 770-0943, Japan.
Received date: 15 July 2022; Accepted date: 16 August 2022; Published date: 20 August 2022
Citation: Bando H. Latest Standard Management for Heart Failure with Guideline-Directed Medical Therapy (GDMT). J Health Care and Research. 2022 Aug 20;3(2):35-40.
Copyright © 2022 Bando H. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Sodium–Glucose Cotransporter 2 Inhibitor, Left Ventricular Ejection Fraction, Heart Failure with Mildly Reduced EF, Guideline-Directed Medical Therapy, 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Abbreviations: ACEi: Angiotensin-Converting Enzyme Inhibitor; ARB: Angiotensin Receptor Blocker; ARNi: Angiotensin Receptor-Neprilysin Inhibitor; COR: Class of Recommendation; GDMT: Guideline-Directed Medical Therapy; HF: Heart Failure; HFmrEF: Heart Failure with Mildly Reduced Ejection Fraction; HFimpEF: Heart Failure with Improved Ejection Fraction; HFrEF: Heart Failure with Reduced Ejection Fraction; HFpEF: Heart Failure with Preserved Ejection Fraction; LVEF: Left Ventricular Ejection Fraction; MRA: Mineralocorticoid Receptor Antagonist; SGLT2i: Sodium-Glucose Cotransporter 2 Inhibitor; CANVAS: Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke; DECLARE-TIMI 58 trial: Dapagliflozin Effect on Cardiovascular Events – Thrombolysis in Myocardial Infarction 58; EMPEROR-Reduced: Empagliflozin in Patients with Chronic Heart Failure and a Reduced Ejection Fraction; DAPA-HF: The Dapagliflozin and Prevention of Adverse‐Outcomes in Heart Failure (DAPA‐HF) Trial; EMPA-REG OUTCOME: (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) study
Sodium–glucose cotransporter 2 inhibitor (SGLT2i) has been attracting attention for novel agent for patients with diabetes and also heart failure (HF), in which the left ventricular ejection fraction (LVEF) has decreased. For standard cardiovascular treatment, 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure is recently presented. Some important perspectives were found, which are HF with mildly reduced EF (HFmrEF), HF with improved EF (HFimpEF) and HF with preserved EF (HFpEF). For patients with HFmrEF, SGLT2i can contribute reducing HF hospitalizations and cardiovascular death. From now, the guideline-directed medical therapy (GDMT) will contribute the standard and beneficial therapy.