[New therapeutic options in heart failure: the importance of the left ventricular ejection fraction].

Heart failure is a chronic illness with a high prevalence and mortality rate. The aim of this article is to give an update on new treatment options for heart failure and the value of the left ventricular ejection fraction (LVEF) in the diagnosis and treatment of heart failure. Based on LVEF, three groups of heart failure can be distinguished: (1) heart failure with reduced ejection fraction (HFrEF; LVEF ≤ 40%), (2) heart failure with mildly reduced ejection fraction (HFmrEF; LVEF 41-49%) and (3) heart failure with preserved ejection fraction (HFpEF; LVEF ≥ 50%). The treatment of HFrEF consists of four pillars, the application of which leads to symptom reduction and better survival: (1) angiotensin converting enzyme inhibitor (ACE-i) or angiotensin receptor-neprilysin inhibitor (ARNI), (2) β-blocker, (3) mineralocorticoid receptor antagonist (MRA) and (4) sodium-glucose co-transporter 2 (SGLT2) inhibitor. ACE-I, β-blocker and MRA can be considered as treatment of HFmrEF. The treatment of HFpEF mainly focuses on symptom reduction.