HardCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 70-year-old man with known HFrEF (LVEF 30%) and ischaemic heart disease is on perindopril, bisoprolol, spironolactone and frusemide at target doses. He remains symptomatic with NYHA class III symptoms despite optimal therapy. According to Australian heart failure guidance, which additional therapy is most appropriate to consider next?