Heart Failure with Reduced Ejection Fraction

Heart failure with reduced ejection fraction (HF-REF) is a common problem worldwide and its prevalence rises with age. It is associated with substantial morbidity and mortality. Development of the condition is driven by a number of haemodynamic and neurohumoral pathophysiological processes which, in turn, lead to adverse remodelling of the myocardium and worsening heart failure. In every case, there is an underlying aetiological factor which triggers this detrimental cascade. The mainstay of treatment is pharmacological, and in select patients this can be complemented by the use of implantable devices or other more approaches techniques. This chapter provides an overview of the pathophysiology of HF-REF, with a focus on the evidence-based treatments currently used.