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CME: Best practices and next directions in the management of chronic heart failure with reduced ejection fraction (HFrEF): getting to the heart of the matter

Activity Description / Statement of Need:

In this online, self-learning activity:

Heart failure (HF) is a clinical syndrome arising from diminished ventricular filling or ejection of blood. HF with reduced ejection fraction (HFrEF) is characterized by systolic dysfunction and a left ventricular ejection fraction (LVEF) of 40%. The prevalence of HF in the U.S. is about 6.7 million, and the lifetime risk has increased in recent decades to 22.6% in women and 25.3% in men. HFrEF constitutes a major public health concern, with five-year survival rates of just under 25%, and it carries with it a significant risk of emergency department visits and hospitalizations.

Target Audience:

HCPs including: cardiologists and PCPs; physician assistants, nurse practitioners, and pharmacists who practice in cardiology; and any other HCPs with an interest in or who clinically encounter patients with HFrEF.

Commercial Support Disclosure: This program is supported by an educational grant from Merck. 

This activity is free of charge.

Release Date: June 15, 2024 -- Expiration Date: June 15, 2026

Faculty: Matthew Budoff, MD


Faculty introduction, disclosures  

HFrEF introductory content 

  • Epidemiology 
  • Pathophysiology: structural and functional changes 
  • Burden of HFrEF on patients and the healthcare system 

Treatment of HFrEF 

  • Present pharmacotherapy, clinical trial findings, and guideline updates, with a focus on outpatient management of chronic HF 
  • Initial therapy 
  • RASis 
  • Beta blockers 
  • MRBs 
  • SGLT2is 
  • Ongoing symptoms and the roles of: 
  • Hydralazine with isosorbide dinitrate 
  • Soluble guanylate cyclase stimulation 
  • If channel inhibition 
  • Digoxin 
  • Investigational therapy: cardiac myosin activation 
  • Practical considerations in therapeutic optimization 
  • Management of associated condition (e.g., valvular disease, ischemic heart disease, arrhythmias) 
  • Importance of initiating therapy soon after diagnosis: focus on outcomes 
  • Medication adverse effects: which ones should alter the course of treatment, and when? 
  • Medication adherence and barriers to attaining target dose 
  • Difficult cases: treatment-refractory outpatients 
  • Facilitating referral to a specialist 
  • Patient case(s)

Summary, conclusions, and best practice recap 

Learning Objectives

By the end of the session the participant will be able to:

  • Summarize the health burden unique to patients with heart failure (HF) and challenges to optimal management.
  • Recall the present and emerging therapies for HF with reduced ejection fraction (HFrEF) and their current or anticipated roles in the treatment paradigm.
  • Develop a treatment plan for a patient with HF.


ACCME Activity #202792417

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours  of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-24-014-H01-P. This is an Application (A)-type activity. ACPE credit release date: 6/30/2024; ACPE credit expiration date: 6/15/2026.

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurses: The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts AMA PRA Category 1 Credit™ assigned by organizations accredited by the ACCME as satisfying Category 1 CME for National Commission on Certification of Physician Assistants (NCCPA) national certification maintenance. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Board (AANPCB) states that continuing education providers accredited by the ACCME may provide acceptable, accredited Advanced Practice Provider content. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Matt Budoff, MD, FACC, Professor of Medicine, David Geffen School of Medicine at UCLA, has received financial compensation from Merck, Astra Zeneca and Boehringer Ingleheim for speaker's bureau work; in addition to grant/research support for Merck.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.  

Faculty WILL NOT discuss off-label uses of a commercial product. 

All relevant financial relationships have been mitigated. 

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Merck. 


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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