A Pilot Study to Increase Utilization of GDMT in Patients With HFrEF

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