Visual Summary

HFpEF, Device Therapy, and Special Populations

Module 7 — Introduction to Medical Pharmacology

Two Different Diseases, Two Different Drug Responses

Pumping Problem

Heart Failure with Reduced Ejection Fraction

  • Driven by neurohormonal activation
  • Four pillars of therapy all proven effective

Relaxation Problem

Heart Failure with Preserved Ejection Fraction

  • Driven by systemic inflammation from obesity, hypertension, diabetes
  • Most RAAS and beta-blocker trials have failed
  • SGLT2 inhibitors are the exception that works

Closing Points

Device therapy does not replace drug therapy Amiodarone raises digoxin levels Most HF drugs need caution, not avoidance, in chronic kidney disease RAAS blockers are contraindicated throughout pregnancy