Medicus, Vol. 34. No. 1. KRM zdravlje, 2025.
Review article
Pharmacological and Non-Pharmacological Heart Failure Treatment with Reduced Systolic Function
Matias Trbušić
Petra Radić
Abstract
In spite of increasingly successful treatment, heart failure (HF) is a growing public health challenge both in the world and in the Republic of Croatia. HF treatment and reduced left ventricular ejection fraction (HFrEF) is based on four key pharmacological pillars, whose efficacy has been confirmed in numerous large randomized clinical trials. It is shown that early implementation of all therapeutic groups, with rapid titration to target doses, significantly reduces mortality and number of hospitalizations, and improves the functional capacity and patients’ quality of life. Introducing treatment requires frequent clinical and laboratory monitoring for timely recognition of side effects. Given the constraints of pharmacological therapy, non-pharmacological methods are playing an increasingly vital role. In addition to typical measures such as education, lifestyle changes and improved dietary habits, specific intervention methods are also accessible and individually adapted based on the etiology of the disease, comorbidities and expected clinical response. Among the most important procedures that are progressively being implemented and examined in recent studies are the following: electrophysiological interventions (ablation of atrial fibrillation, ventricular tachycardia and PVCs, resynchronization therapy, conduction system stimulation, implantation of a cardioverter-defibrillator), percutaneous or surgical myocardial revascularization, transcatheter aortic valve implantation (TAVI) and percutaneous mitral valve reconstruction (TEER – transcatheter edge-to-edge repair). Timely and optimally implemented non-pharmacological therapy can improve treatment effects and delay the need for advanced HF treatment methods, such as mechanical circulatory support and heart transplants.
Keywords
heart failure, HFrEF, pharmacological and non-pharmacological therapy
Hrčak ID:
338520
URI
Publication date:
27.10.2025.
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