Work

Durable Remission After Triple Therapy in New-Onset HFrEF

Year: 2026

Type: article

Abstract: BACKGROUND: Although quadruple guideline-directed medical therapy (GDMT) improves outcomes in heart failure with reduced ejection fraction (HFrEF), the optimal method to initiate and sequence quadruple therapy remains uncertain. CASE SUMMARY: Two patients with new-onset HFrEF achieved remission with symptom resolution and near-normalization of left ventricular ejection fraction and elevated N-terminal-pro-B-type natriuretic peptide levels after administration of angiotensin-converting enzyme inhibitor, beta-blocker, and mineralocorticoid receptor antagonist, without angiotensin receptor-neprilysin inhibitor or sodium glucose cotransporter-2 inhibitor. One patient received cardiac resynchronization therapy, and the other patient stopped using alcohol and prescription amphetamine/dextroamphetamine (Adderall). Remission has lasted ≥12 years in both patients. DISCUSSION: Methods are needed to identify which patients with new-onset HFrEF can achieve remission with fewer drugs than quadruple therapy. This personalized GDMT strategy would reduce costs and the risks of drug-related side effects. TAKE-HOME MESSAGE: Durable remission from new-onset HFrEF can be achieved with fewer drugs than quadruple GDMT. Diagnostic tools are needed to identify such patients.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106526

Authors: Michael Pitonak, Jake Munch, Jennifer T. Thibodeau, Mark H. Drazner

Institution: The University of Texas Southwestern Medical Center

Language: English

Topic: Heart Failure Treatment and Management

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850