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  • Modern drugs and the consequent implementation of therapeutic recommendations have substantially improved the morbidity and mortality of heart failure patients.

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    Modern drugs and the consequent implementation of therapeutic recommendations have substantially improved the morbidity and mortality of heart failure patients.

    The basic treatment approach for HFrEF is neurohormonal inhibition by means of angiotensin converting enzyme (ACE) inhibitors, mineralocorticoid receptor antagonists (MRAs), and beta-blockers. This therapy has been proven to be effective in numerous randomised trials.

    In addition to the established drug treatment, treatment with MRA and ivabradine have become standard in symptomatic patients with HFrEF. The combination of sacubitril and valsartan, a first-in-class angiotensin II AT1 receptor neprilysin inhibitor, is a promising new addition to current pharmacological treatments. The overwhelming benefit of sacubitril/valsartan shown in the PARADIGM-HF trial led to a class IB recommendation by the ESC for symptomatic patients.

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