The Role of MRAs in the Management of HF-Best Practices for Incorporating MRAs into the Heart Failure Treatment Armamentarium

Best Practices for Incorporating MRAs into the Heart Failure Treatment Armamentarium

Video Transcription

Video Summary

Emma Siegel and Tara Shreck discuss incorporating mineralocorticoid antagonists (MRAs) into heart failure treatment. MRAs block aldosterone, reducing fibrosis, inflammation, and volume retention. Steroidal MRAs (spironolactone, eplerenone) mainly act on kidneys; non-steroidal finerenone also targets heart tissue. For heart failure with reduced ejection fraction (HFrEF), MRAs are a core therapy with strong guideline support; dosing and monitoring depend on kidney function and potassium levels. In preserved ejection fraction (HFpEF), evidence and recommendations are less clear but suggest benefit, especially with non-steroidal MRAs. Uptake of MRAs remains low due to side effect concerns.

Keywords

mineralocorticoid antagonists

heart failure treatment

spironolactone

finerenone

HFrEF