Abstract：
Heart failure with reduced ejection fraction (HFrEF) has been associated with poor prognosis, reduced quality of life, and increased healthcare expenditure. Despite tremendous advances in HFrEF management, reduced survival and a high rate of hospitalization remain unsolved issues. Furthermore, HFrEF morbidity and economic burden are estimated to increase in the following years; hence, new therapies are constantly emerging. In the last few years, a series of landmark clinical trials have expanded our therapeutic armamentarium with a ground-breaking change in HFrEF-related outcomes. Sodium-glucose co-transporter 2 inhibitors (mainly dapagliflozin and empagliflozin) have already revolutionized the management of HFrEF patients via a significant reduction in cardiovascular mortality and heart failure hospitalizations. Furthermore, vericiguat and omecamtiv mecarbil have emerged as promising and novel disease-modifying therapies. The former restores the impaired cyclic guanosine monophosphate pathway, and the latter stimulates cardiac myosin without marked arrhythmogenesis. Both vericiguat and omecamtiv mecarbil have been shown to reduce heart failure admissions. Sacubitril/valsartan is an established and effective therapy in HFrEF patients and should be considered as a replacement for angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs). Lastly, inflammasome activity is implicated in HFrEF pathophysiology, and the role of anti-inflammatory agents in HFrEF trajectories is readily scrutinized, yet available therapies are ineffective. This mini-review summarizes the major and most recent studies in this field, thus covering the current advances in HFrEF therapeutics.
摘要：
射血分数降低的心力衰竭（HFrEF）与不良预后相关。生活质量下降，增加医疗支出。尽管HFrEF管理取得了巨大的进步，降低生存率和高住院率仍然是未解决的问题。此外，HFrEF发病率和经济负担估计在接下来的几年里会增加；因此，新疗法不断涌现。在过去的几年里，一系列具有里程碑意义的临床试验扩大了我们的治疗性医疗设备,在HFrEF相关结局方面发生了突破性的变化.钠-葡萄糖协同转运蛋白2抑制剂（主要是达格列净和依帕格列净）已经通过显着降低心血管死亡率和心力衰竭住院率而彻底改变了HFrEF患者的管理。此外，Vericiguat和omecamtivmecarbil已成为有前途的新型疾病修饰疗法。前者恢复受损的环磷酸鸟苷途径，后者刺激心肌肌球蛋白而没有明显的心律失常发生。Vericiguat和omecamtivmecarbil都被证明可以减少心力衰竭的入院。Sacubitril/缬沙坦是HFrEF患者的既定有效疗法，应考虑作为血管紧张素转换酶抑制剂（ACEi）或血管紧张素II受体阻滞剂（ARB）的替代品。最后,炎症小体活性与HFrEF病理生理学有关，抗炎药在HFrEF轨迹中的作用很容易被仔细检查，然而，现有的疗法是无效的。这篇小型综述总结了该领域的主要和最新研究，从而涵盖了HFrEF疗法的当前进展。
