22114Managing the Heart Failure Patient with Reduced Ejection Fraction

In this program, HF experts will provide insights into mechanisms for improving myocardial contractility and clinical evidence and emphasize the need for a more personalized treatment of HFrEF.

A central factor in the pathogenesis of heart failure (HF) with reduced
ejection fraction (HFrEF) is the initial decrease in systolic function.
Pharmacological agents that improve myocardial performance can be
categorized based on 3 myocardial mechanisms: calcitropes, which
alter intracellular calcium concentrations; myotropes, which a ect the
molecular motor and scaffolding; and mitotropes, which in uence
energetics. Omecamtiv mecarbil, an investigational therapy which
improves contraction by a novel mechanism of action, has demonstrated
a reduction in the risk of a composite of a first heart failure event or
cardiovascular death, with an excellent safety and tolerability profiie.
New therapies are becoming available for the treatment of HFrEF,
providing the clinician with more opportunities for an individualized
approach to pharmacotherapy. Patients with worsening HF are particularly
challenging; guideline-directed medical therapy (GDMT) often cannot be
optimized in these patients due to a variety of factors (such as multiple
organ system involvement, lower glomerular filtration rate, higher risk of
hyperkalemia, lower systolic blood pressure, and higher risk of medication
side effects/intolerance). There is an unmet need for new therapies to
improve ventricular performance and clinical outcomes in this di cult-totreat
patient population. In this program, HF experts will provide insights
into mechanisms for improving myocardial contractility and clinical
evidence and emphasize the need for a more personalized treatment of
HFrEF. A case discussion will illustrate current best practices for patients
with worsening HF, and identify a potential role for emerging therapies.

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