Approach to empiric pharmacologic therapy for asymptomatic left ventricular systolic dysfunction

ACE: angiotensin converting enzyme; ARB: angiotensin II receptor blocker; HF: heart failure; HFrEF: heart failure with reduced ejection fraction; LV: left ventricular; LVEF: left ventricular ejection fraction; MI: myocardial infarction; MRA: mineralocorticoid receptor antagonist; RAAS: renin-angiotensin-aldosterone system.

* Refer to UpToDate topics on HFrEF for details on pharmacologic therapy including contraindications, cautions, dosing, monitoring, and management of the multidrug regimen (eg, sequence of therapy).

¶ Assessment of multiple measures of LV function are required to establish a true change in systolic function. For further details, including measures of LV systolic function other than ejection fraction, refer to UpToDate topics on assessment of left ventricular systolic function.