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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

25
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

34
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
34
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

412
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Food Supplementation in Patients Hospitalized for Heart Failure: A Randomized Clinical Trial.

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Reply: Semaglutide in Frail HFpEF: Need for Objective Functional Measures and Body Composition Assessment.

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Related Experiment Video

Updated: Aug 17, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

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Inconsistent Outcome Reporting in Heart Failure Randomized Controlled Trials.

Tariq Jamal Siddiqi1, Izza Shahid2, Muhammad Sameer Arshad3

  • 1Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Journal of Cardiac Failure
|December 13, 2022
PubMed
Summary

Over 13% of heart failure randomized controlled trials (RCTs) reported outcomes differently than initially planned. This highlights a need for greater transparency in clinical trial reporting to prevent selective outcome reporting.

Keywords:
Heart failureoutcome reportingoutcomesretrospective registration

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Area of Science:

  • Clinical Trials
  • Cardiology
  • Medical Research Integrity

Background:

  • Randomized controlled trials (RCTs) are crucial for evidence-based medicine.
  • Discrepancies between prespecified and reported outcomes in RCTs can impact scientific integrity.
  • Heart failure (HF) trials are a significant area of clinical research where outcome reporting consistency is vital.

Purpose of the Study:

  • To determine the prevalence of outcome reporting inconsistencies in heart failure (HF) randomized controlled trials (RCTs).
  • To characterize the types of outcome reporting discrepancies found in HF RCTs.
  • To identify factors associated with outcome reporting inconsistencies in HF RCTs.

Main Methods:

  • A systematic search of MEDLINE via PubMed was conducted for phase II-IV HF RCTs published in high-impact journals between 2010 and 2020.
  • Outcomes in trial publications were compared against prespecified outcomes in protocols, registration websites, and statistical analysis plans (SAPs).
  • Statistical tests (chi-squared or Fisher exact) were used to analyze correlations between trial characteristics and outcome reporting inconsistencies.

Main Results:

  • Out of 216 HF RCTs analyzed, 28 trials (13.0%) exhibited 32 outcome reporting inconsistencies.
  • Common inconsistencies included omission of primary/secondary outcomes, changes in outcome status (primary to secondary and vice versa), and addition of new secondary outcomes.
  • A significant proportion (36.1%) of inconsistent outcomes were retrospectively registered, and single-center recruitment was associated with outcome inconsistencies.

Conclusions:

  • More than 10% of HF RCTs report outcomes that differ from those prespecified in registration, protocols, or SAPs.
  • These inconsistencies, often favoring statistically significant findings, raise concerns about selective outcome reporting.
  • An action plan is necessary to enhance transparency and minimize selective reporting in clinical trials.