ArticleJACC. Case reports2026
Durable Remission After Triple Therapy in New-Onset HFrEF: Implications for a Strategy of "Personalized GDMT".
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough quadruple guideline-directed medical therapy (GDMT) improves outcomes in heart failure with reduced ejection fraction (HFrEF), the optimal method to initiate and sequence quadruple therapy remains uncertain. CASE SUMMARY: Two patients with new-onset HFrEF achieved remission with symptom resolution and near-normalization of left ventricular ejection fraction and elevated N-terminal-pro-B-type natriuretic peptide levels after administration of angiotensin-converting enzyme inhibitor, beta-blocker, and mineralocorticoid receptor antagonist, without angiotensin receptor-neprilysin inhibitor or sodium glucose cotransporter-2 inhibitor. One patient received cardiac resynchronization therapy, and the other patient stopped using alcohol and prescription amphetamine/dextroamphetamine (Adderall). Remission has lasted ≥12 years in both patients. DISCUSSION: Methods are needed to identify which patients with new-onset HFrEF can achieve remission with fewer drugs than quadruple therapy. This personalized GDMT strategy would reduce costs and the risks of drug-related side effects. TAKE-HOME MESSAGE: Durable remission from new-onset HFrEF can be achieved with fewer drugs than quadruple GDMT. Diagnostic tools are needed to identify such patients.
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