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Volume 407,
Issue 10527

Seminar

Open Access

p529–542 January 31, 2026

Heart failure with reduced ejection fraction

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Affiliations & Notes

A.

British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine, Faculty of Life Science, King's College London, London, UK

B.

Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK

C.

Servicio de Cardiología. Complexo Hospitalario Universitario A Coruña, Centro de Investigación Biomédica en Red Cardiovascular, Universidad de A Coruña, Spain

D.

Department of Cardiology, University Hospital Zurich; Center for Translational and Experimental Cardiology, University of Zurich, Switzerland

CORRECTION:

Errata

Department of Error

January 31, 2026

SUMMARY

Heart failure is a complex clinical syndrome affecting around 70 million individuals globally. It has a prevalence of 2% in Europe and North America and approximately 1% in Asia and South America. Accurate diagnosis relies on the presence of typical signs and symptoms, elevated natriuretic peptide concentrations, and evidence of cardiac structural or functional abnormalities using cardiac imaging techniques.

Approximately half of all heart failure cases are attributed to reduced left ventricular systolic function—classified as heart failure with reduced ejection fraction (HFrEF). Current guideline-directed medical therapy has markedly improved survival and quality of life for patients with HFrEF. Contemporary management emphasises early initiation and rapid uptitration of four foundational drug classes—renin-angiotensin system inhibitors or angiotensin receptor-neprilysin inhibitors, β blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors.

Despite advances in management, heart failure remains a leading cause of cardiovascular morbidity and mortality, partly due to absence of implementation of, and poor adherence to, medications. Future directions to improve outcomes include the integration of personalised medicine approaches, multiomic profiling, and innovative clinical trial designs to address residual risk and identify novel therapeutic targets.

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REFERENCES

1.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

2.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

3.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

4.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

5.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

6.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

7.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

8.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

9.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763

10.

Delmonico, RL • Theodore, BR • Sandel, ME • et al.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
PM R. 2022; 14:753-763