Expert Perspectives on the Updated ACC Decision Pathway for Optimization of Heart Failure Treatment

Javed Butler, MD, MPH, MBA, discusses the staging and difficulties associated with diagnosing heart failure.

The role of early aggressive treatment in preventing progression of heart failures and the importance of understanding the root cause of disease.

A look into the role of heart failure treatment in health care and the overall provision of optimal medical therapy.

Using the ACC Expert Consensus Decision Pathway documents for the optimization of heart failure treatment and managing the increasing complexity of the disease.

Experts in cardiology provide a brief history on treatments used for heart failure including ACE (angiotensin converting enzyme) inhibitors and beta blockers.

A discussion on the safety and efficacy of angiotensin receptor-neprilysin inhibitor (ARNI), sacubitril/valsartan, for the treatment of heart failure.

Considerations for initiating sacubitril/valsartan as de novo therapy in patients naïve to angiotensin-converting enzyme inhibitors or angiotensin receptor blocker therapies as per the 2021 update of the expert consensus decision pathway document.

Contraindications for clinicians to keep in mind when administering sacubitril/valsartan therapy, and an examination of target dose for therapies in heart failure with reduced ejection fraction.

Evaluating the facilitation of an MRA (mineralocorticoid receptor antagonist) when using an optimal adjuvant medical therapy for the treatment of heart failure.

Javed Butler, MD, MPH, MBA, reviews the historical background of using SGLT2 inhibitors and the impact on patients with heart failure with reduced ejection fraction.

Insights on approaching the initiation of SGLT2 inhibitors for the treatment of heart failure with reduced ejection fraction.

Cardiology experts discuss challenges in achieving the optimal therapy for patients with heart failure and the influence of patient lifestyle and medical factors.

James Januzzi, MD, and Javed Butler, MD, MPH, MBA, discuss emerging agents, vericiguat and intravenous (IV) iron, in the treatment landscape for heart failure with reduced ejection fraction and advice for community physicians managing patients with heart failure.