PC3 MOD 6.2

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6 Terms

1
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4 pillars fo HFrEF GDMT

  1. ARNI… ACEi… ARB (RAAS inh)

  2. BB (decreased SNS activation)

  3. MRA (aldosteroe inh)

  4. SGLT2i (increased osmotic diuresis & natriuresis


2
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RAS inh

  • ARNI- Ang receptor/neprilysin inh

  • ACEi- ACE inh

  • ARB- Ang receptor blocker


3
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neprilysin breaks down NPs

  • ANP & BNP work in opposition to RAS

  • inh neprilysin breakdown keeps ANP & BNP in circulation promoting beneficial effects ( natriuresis/diuresis, vasodilation, anti-hypertrophy, inh of SNS)


4
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selective BBs

  • FDA approved= metoprolol succinate ER & carvedilol

  • guideline recommended= bisoprolol


5
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importance of using BBs for HF

  • decreasing HR & contractility will reduce MVO2→ reducing cardiac work

    • less hypertrophy

    • more time for relaxation & filling (higher preload)

  • normalize Ca handling

  • decrease arrhythmias


6
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