###### Abstract  
Heart failure is a progressive disease that leads to high mortality rates if left untreated, and introduces are a class of drugs used to treat a type of heart failure where patients have reduced ejection fraction (HFrefE). This study aims to utilize the Fuzzy-Preference Ranking Organization Method for Enrichment Evaluation (F-PROMETHEE), an effectively used multi-criteria decision making (MCDM) technique. To analyze the characteristics of the most often used inotropes for acute HFref and chronic HFrefE, we use the same parameters set with distinct importance factors and aims for each property and, therefore, mathematically demonstrate the strengths and weaknesses of each inotrope alternative. As a result, a detailed ranking list for each HFref class was obtained, with supplementary information on how each parameter contributed to the ranking of each inotrope. From these results, it was concluded that the F-PROMETHEE method is applicable for evaluating the risks and benefits of various inotropes to determine a starting point for treating an average patient when making a quick decision without complete patient data. As demonstrated in this study, it is possible to easily use the same data set and only change some preference parameters according to individual needs to produce patient-specific results. In this study, we showed that creating a decision-making system that mathematically assists clinical specialists with their decision-making process is feasible. multi-criteria decision making; fuzzy logic; PROMETHEE; heart failure; reduced ejection fraction; acute; chronic; inotropes +
Footnote †: journal: Medical and Health Sciences  
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Ejection fraction (EF) is a common measurement of HF patients, and it defines the percentage of blood pumped out of the left ventricle of the heart; 50-70% EF is considered to be normal. There are two sub types of heart failure, preserved EF and reduced EF heart failure, where the presenting sub type creates an important distinction on how the patient needs to be treated [4]. Preserved ejection fraction (HFpEF) usually means that the EF is normal but heart failure is caused by decreased blood intake into the left ventricle during diastole. Therefore, a reduced blood volume is available to the body [5]. Reduced ejection fraction (HFrEF) usually means that although the left ventricle fills with a sufficient volume of blood, the heart muscles cannot contract with sufficient force, so that produced EF is insufficient for the body [5; 6]. About 6.2 m people suffer from heart failure in the US [1], and 65% of these patients have preserved ejection fraction while 35% have reduced ejection fraction [7; 8]. This study focuses on HFrEF patients, who require a specific type of drug called indorpes to manage the most severe symptoms of heart failure by increasing contractility and thereby reducing hospitalization time [9; 10; 11; 12]. Inotropes, along with their vasopressor effects, aim to improve myocardial contractility and vital organ perfusion to alleviate life-threatening symptoms of HFrEF [9; 10; 11; 12]. There are multiple types of indorpes, which are classified according to how they affect myocardial contractility. Those most widely used in clinical practices are catecholamines and phosphodiesterase inhibitors (PDIs). Inotropes are meant to act as short- to medium-term assistive drugs, intending to provide hemodynamic stability that will carry the patient to a point where a more invasive or permanent solution can be discussed and realized as necessary. These solutions include coronary revascularization, total heart transplant, left ventricular assist device, intra-aortic balloon pump, extracorporeal membrane oxygenation, etc.