Description
Inclusion Criteria:
- * Diagnosis of HFrEF (left ejection fraction \< 40%, assessed by transthoracic echo, cardiac MRI, cardiac SPECT) within the past year.
- * New York Heart Association (NYHA) class II-III at most recent screening assessment.
- * GDMT composite score of less than or equal to 50% at baseline
Exclusion Criteria:
- * Previous contraindication to beta blockers, ACE inhibitors, and/or ARB.
- * Baseline creatinine \> 2 mg/dl or potassium level at baseline \> 5 mEq/L or eGFR \<30 mL/min/1.73 m2.
- * Baseline systolic blood pressure \< 100 mmHg.
- * Concomitant use of ACE, ARB, and/or ARNI
- * Polycystic kidney disease
- * History of angioedema
- * History of or currently on a transplant list
- * Left ventricular assist device
- * Uncontrolled asthma
- * Severe COPD
- * Cirrhosis
- * Currently receiving hospice or comfort care
- * Patient not proficient with written and spoken English
- * Patient has diminished decision making capability
- * History of non-compliance
Ages Eligible for Study:
18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No