저도 말씀하신 부분이 궁금하네요 low bp는 mra cotraindication이 아닌 것 같습니다.

저 문제에서 mra가 배제될 이유가 있을 지 궁금하네요

Yes, mineralocorticoid receptor antagonists (MRAs) can be used in a patient with heart failure with reduced ejection fraction (HFrEF) and a blood pressure of 95/65 mmHg, provided there are no contraindications such as significant renal dysfunction (eGFR ≤30 mL/min/1.73m²) or hyperkalemia (serum potassium ≥5.0 mEq/L). Low blood pressure alone is not a contraindication to MRA therapy, as MRAs have minimal direct antihypertensive effect compared to other heart failure medications.

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DCMP 라는 게 매우 다르죠…

3개월 이상 치료에도 불구하고, LVEF 35% 이하일 경우, ICD or CRT에 대해 고려해볼 수 있다는 내용이 있네요.

Persistently reduced LVEF ≤35% despite GDMT(Guideline-directed medical therapy) for ≥3 months: Refer for consideration of device therapy in those patients without prior placement of ICD or CRT, unless device therapy is contraindicated or inconsistent with overall goals of care Reference : 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee

질문 뭐였음? MRA가 답이 안되는 이유에 대해서 물으셨나요?