{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T03:49:03Z","timestamp":1792986543671,"version":"4.5.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Despite guideline recommendations and available evidence, implementation of treatment in heart failure (HF) is poor. The majority of patients are not prescribed drugs at target doses that have been proven to positively impact morbidity and mortality. Among others, tolerability issues related to low blood pressure, heart rate, impaired renal function or hyperkalaemia are responsible. Chronic kidney disease plays an important role as it affects up to 50% of patients with HF. Also, dynamic changes in estimated glomerular filtration rate may occur during the course of HF, resulting in inappropriate dose reduction or even discontinuation of decongestive or neurohormonal modulating therapy in clinical practice. As patients with HF are rarely na\u00efve to pharmacologic therapies, the challenge is to adequately prioritize or select the most appropriate up-titration schedule according to patient profile. In this consensus document, we identified nine patient profiles that may be relevant for treatment implementation in HF patients with a reduced ejection fraction. These profiles take into account heart rate (&amp;lt;60 bpm or &amp;gt;70 bpm), the presence of atrial fibrillation, symptomatic low blood pressure, estimated glomerular filtration rate (&amp;lt;30 or &amp;gt;30\u2009mL\/min\/1.73\u2009m2) or hyperkalaemia. The pre-discharge patient, frequently still congestive, is also addressed. A personalized approach, adjusting guideline-directed medical therapy to patient profile, may allow to achieve a better and more comprehensive therapy for each individual patient than the more traditional, forced titration of each drug class before initiating treatment with the next.<\/jats:p>","DOI":"10.1002\/ejhf.2206","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T10:42:54Z","timestamp":1619865774000},"page":"872-881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":250,"title":["Patient Profiling in Heart Failure for Tailoring Medical Therapy. A Consensus Document of the Heart Failure Association of the European Society of Cardiology"],"prefix":"10.1093","volume":"23","author":[{"given":"Giuseppe M.C.","family":"Rosano","sequence":"first","affiliation":[{"name":"IRCCS San Raffaele Pisana , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Moura","sequence":"additional","affiliation":[{"name":"Armed Forces Hospital , Porto ,","place":["Portugal"]},{"name":"Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Saarland University Hospital , Homburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuvia","family":"Ben Gal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rabin Medical Centre , Petah Tikva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stamatis","family":"Adamopoulos","sequence":"additional","affiliation":[{"name":"Onassis Cardiac Surgery Center , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdy","family":"Abdelhamid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Cairo University , Giza ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Bistola","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital, University of Athens Medical School , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"\u010celutkien\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, State Research Institute Centre for Innovative Medicine , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[{"name":"University of Medicine Carol Davila , Bucharest ,","place":["Romania"]},{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. Iliescu\u2019 , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Farmakis","sequence":"additional","affiliation":[{"name":"University of Cyprus Medical School , Nicosia ,","place":["Cyprus"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care & Research , Cotignola ,","place":["Italy"]},{"name":"Centro Cardiologico Universitario di Ferrara, University of Ferrara , Ferrara ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, School of Medicine, University Hospital Attikon , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loreena","family":"Hill","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Queen\u2019s University Belfast , Northern Ireland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa A.","family":"Jankowska","sequence":"additional","affiliation":[{"name":"Department of Heart Diseases, Wroclaw Medical University and Center for Heart Diseases, University Hospital in Wroclaw , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiny","family":"Jaarsma","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Linkoping University , Link\u00f6ping ,","place":["Sweden"]},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pardeep","family":"Jhund","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitja","family":"Lainscak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, General Hospital Murska Sobota , Murska Sobota ,","place":["Slovenia"]},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana ,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Lopatin","sequence":"additional","affiliation":[{"name":"Volgograd State Medical University, Regional Cardiology Centre Volgograd , Volgograd ,","place":["Russian Federation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davor","family":"Milicic","sequence":"additional","affiliation":[{"name":"University of Zagreb School of Medicine , Zagreb ,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences, BIOMED - Biomedical Research Institute, Hasselt University , Diepenbeek ,","place":["Belgium"]},{"name":"Department of Cardiology, Ziekenhuis Oost , Genk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Pinto","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Santa Maria (CHULN), CAML, CCUL, Faculty of Medicine, University of Lisbon , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Faculty of Health Sciences, Wroclaw Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Thum","sequence":"additional","affiliation":[{"name":"Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Volterrani","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Pisana , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar M.","family":"Seferovic","sequence":"additional","affiliation":[{"name":"Department Faculty of Medicine, University of Belgrade , Belgrade ,","place":["Serbia"]},{"name":"Serbian Academy of Sciences and Arts , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"University of Warwick , Coventry ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"2026080801014480400_ejhf2206-bib-0001","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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