Year: 2021
Type: review
Abstract: The recent U.S. Food and Drug Administration expanded indication for sacubitril/valsartan introduces a new potential taxonomy for heart failure, with no reference to "preserved" ejection fraction but referring to "below normal" ejection fraction as those most likely to benefit. This review summarizes the evolution of nomenclature in heart failure and examines evidence showing that patients with ejection fraction in the "mid range" may benefit from neurohormonal blockade similar to those with more severely reduced (<40%) ejection fraction. Furthermore, prominent sex differences have been observed wherein the benefit of neurohormonal blockade appears to extend to a higher ejection fraction range in women compared to men. Based on emerging evidence, revised nomenclature is proposed defining heart failure with "reduced" (<40%), "mildly reduced," and "normal" (≥55% in men, ≥60% in women) ejection fraction. Such nomenclature signals consideration of potentially beneficial therapies in the largest group of patients with reduced or mildly reduced ejection fraction.
Authors: Carolyn S.P. Lam, Scott D. Solomon
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,600
Funders: Amgen, Bristol-Myers Squibb, AstraZeneca, GlaxoSmithKline, Sanofi, Brigham and Women's Hospital, Gilead Sciences, Alnylam Pharmaceuticals, Boston Scientific Corporation, Celladon Corporation, Ironwood Pharmaceuticals, Incorporated, Cytokinetics, Duke-NUS Medical School, MyoKardia, Novo Nordisk, Vifor Pharma, Menarini Group, National Institutes of Health, Abbott Diagnostics, Sanofi Pasteur, National Heart, Lung, and Blood Institute
OpenAlex ID: W3173564302