Management of HFrEF often involves multidisciplinary care, may require complex decision-making, and bene ts from a solid foundation of knowledge to manage these occasionally fragile patients. HF is a major public health concern, one in which broader clinician experience in GDMT would be expected to signi cantly bene t affected patients. With recent changes in available diagnostics and therapeutics for HFrEF, along with the evolution in rec- ommended management strategies for affected patients, many questions have emerged regarding optimal deploy- ment of these newer approaches to patient care. Addi- tionally, clinical practice guidelines continue to evolve. In this context, we have highlighted important literature ci- tations explaining the rationale for this changing picture in HFrEF care, candidate best practices, and, where evidence or best practices are lacking, templates for clinical decision-making to manage patients rationally. As more evidence emerges, many more topics will be clari ed ACC PRESIDENT AND STAFF Athena Poppas, MD, FACC, President Cathleen C. Gates, Chief Executive Of cer John Rumsfeld, MD, PhD, FACC, Chief Science and Quality Of cer Joseph M. Allen, MA, Team Leader, Clinical Standards and Solution Sets Amy Dearborn, Team Leader, Clinical Policy Content Development Ashleigh M. Covington, MA, Team Leader, Clinical Pathways and Heart House Roundtables Severa Chavez, Manager, Clinical Pathways and Policy Grace D. Ronan, Team Lead, Clinical Policy Publication Maddox et al. J R E F E R E N C E S 1. Januzzi JL Jr., Ahmad T, Binder LG, et al. 2019 methodology for creating expert consensus decision pathways: a report of the American College of Cardi- ology. J Am Coll Cardiol. 2019;74:1138 50. 2. Yancy CW, Januzzi JL Jr., Allen LA, et al. 