Insuficiencia cardíaca crónica con fracción de eyección ventricular izquierda reducida y ligeramente reducida

Abstract

Heart failure with reduced or slightly reduced ejection fraction is defined as a clinical syndrome characterized by the presence of symptoms and/or signs arising from structural and/or functional abnormality of the heart. It is confirmed by elevated natriuretic peptide levels or objective evidence of pulmonary or systemic congestion in addition to a decreased left ventricular ejection fraction equal to or less than 40% or between 41%–49%, respectively. Its most frequent etiology is coronary artery disease followed by hypertension, valvular heart disease, and cardiomyopathies, among others. Its diagnosis is based on an interview with suggestive symptoms and typical clinical signs of heart failure. It is essential to perform an electrocardiogram, NT-proBNP measurement, and echocardiogram as well as additional tests according to the patient's clinical context. Treatment includes lifestyle changes, diuretics to control fluid overload and congestive symptoms, and drugs with prognostic implications. There are four main drug groups: beta-adrenergic blockers, angiotensin receptor-neprilysin inhibitors, mineralocorticoid antagonists, and SGLT2 inhibitors.