{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:40:23Z","timestamp":1777419623433,"version":"3.51.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"Supplement_L","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Large randomized controlled trials (RCTs) have led to major changes in the treatment of patients with heart failure and reduced left ventricular ejection fraction (HFrEF) and these advances are included in the recent European Society of Cardiology (ESC) and the American College of Cardiology\/American Heart Association\/Heart Failure Society of America (ACC\/AHA\/HFSA) guidelines issued in 2021 and 2022, respectively. According to both guidelines, treatment of patients with HFrEF is based on the administration of four classes of drugs that reduce the primary endpoint of cardiovascular death and HF hospitalizations in RCTs: angiotensin-converting enzyme or angiotensin receptor neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter 2 inhibitors. Specific sequences of treatment are not recommended but emphasis is given to reaching treatment with all four drugs as early as possible. Further treatments are considered in selected patients including ivabradine, hydralazine nitrates, digoxin, and the new agent vericiguat. Specific treatments, mostly new, for cardiovascular and non-cardiovascular comorbidities are also given. The aim of this article is to compare the two recent guidelines issued by the ESC and ACC\/AHA\/HFSA and show the few differences and the many consistent recommendations, now more numerous given the evidence available for many new treatments.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suac124","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T21:32:40Z","timestamp":1671485560000},"page":"L20-L28","source":"Crossref","is-referenced-by-count":12,"title":["Aiming at harmony. Comparing and contrasting International HFrEF Guidelines"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7584-2857","authenticated-orcid":false,"given":"Daniela","family":"Tomasoni","sequence":"first","affiliation":[{"name":"Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biykem","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Winters Center for Heart Failure, Cardiovascular Research Institute, Baylor College of Medicine, Michael E. DeBakey VA Medical Center , Houston, TX , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"United States Department of Veterans Affairs, Veterans Affairs Palo Alto Health Care System , 3801 Miranda Avenue, Palo Alto, CA 94304 , USA"},{"name":"Department of Medicine, Stanford University School of Medicine , Stanford, CA 94305 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"McDonagh","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences, King\u2019s College London British Heart Foundation Centre of Excellence , London , UK"},{"name":"Department of Cardiology, King\u2019s College Hospital NHS Foundation Trust , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe M C","family":"Rosano","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana , via della Pisana, 235, 00163 Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean A","family":"Virani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of British Columbia , Vancouver, British Columbia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelley","family":"Zieroth","sequence":"additional","affiliation":[{"name":"Department of Medicine, St. Boniface General Hospital, University of Manitoba , Winnipeg, Manitoba , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"2023021409524207200_suac124-B1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"24","author":"McDonagh","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2023021409524207200_suac124-B2","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice 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