Clinical Research Directory

Inclusion Criteria: * HFrEF with already established or newly started treatment with the listed medicinal products * Male and female patients over 18 years of age * Signed Informed Consent with participation in the study * Women of childbearing potential must have a negative serum human chorionic gonadotropin (hCG) result at baseline and use an acceptable method of contraception with a home control urine pregnancy test every 3 months throughout the duration of the study Exclusion Criteria: * Hypersensitivity to the medicinal substance or to any auxiliary substance * Pregnant and breastfeeding women * Additional exclusion criteria for patients taking Bisoprolol, Carvedilol, Metoprolol succinate or Nebivolol: Unstable or decompensated heart failure belonging to New York Heart Association (NYHA) group IV according to the New York Heart Association classification, requiring intravenous inotropic support * Additional exclusion criteria for patients using Bisoprolol, Carvedilol, Metoprolol succinate or Nebivolol: * \- Clinically manifest liver dysfunction * \- History of bronchospasm or asthma * \- Severe obstructive airways disease * \- 2nd and 3rd degree A-V block (unless a permanent pacemaker is implanted) * \- severe bradycardia (heart rate \<50) * \- 2nd and 3rd degree A-V block (unless a permanent pacemaker is implanted) * \- severe bradycardia (heart rate \<50) * \- cardiogenic shock * \- sinus node dysfunction syndrome (including sinoatrial block) * \- severe hypotension (systolic blood pressure \<85 mmHg) * \- Prinzmetal angina * \- untreated pheochromocytoma * \- metabolic acidosis * \- severe peripheral arterial circulation disorders * \- concurrent intravenous treatment with verapamil or diltiazem * Additional exclusion criteria for patients using Spironolactone: * \- anuria * \- acute renal failure * \- severe renal impairment (estimated glomerular filtration rate \<10 ml/min) * \- hyperkalemia \>5.5 mmol/l * \- hyponatremia \<125 mmol/l * \- Addison's disease * \- concurrent use of eplerenone or other potassium-sparing diuretics * \- porphyria * Additional exclusion criteria for patients using Sacubitril/Valsartan: * \- concomitant use with Angiotensin converting enzyme (ACE) inhibitors * \- angioedema related to previous ACE inhibitor treatment or a history of angiotensin II receptor blockers (ARB) treatment * \- hereditary or idiopathic angioedema * \- concomitant use with medicinal products containing Aliskiren in patients with diabetes mellitus or in patients with impaired renal function (eGFR \<60 ml/min/1.73 m2) * \- severe liver dysfunction, biliary cirrhosis and cholestasis