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Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

14
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
14
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

20
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...
20
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

1.6K
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...
1.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

463
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...
463
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

97
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Related Experiment Video

Updated: Jul 21, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

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DASH-HF Study: A Pragmatic Quality Improvement Randomized Implementation Trial for Patients With Heart Failure With

Aradhana Verma1, Gregg C Fonarow2, Jeffrey J Hsu2,3

  • 1Department of Medicine (A.V., A.N.), David Geffen School of Medicine at the University of California, Los Angeles.

Circulation. Heart Failure
|July 26, 2023
PubMed
Summary

A dashboard-based telehealth intervention did not improve medication adherence or reduce hospitalizations for heart failure patients. Further research is needed to optimize this approach for better heart failure management.

Keywords:
guideline-directed medical therapyheart failure with reduced ejection fractionmedicationsquality improvementtelehealth

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Area of Science:

  • Cardiology
  • Health Services Research
  • Digital Health

Background:

  • Heart failure (HF) is a leading cause of hospitalization and mortality.
  • Guideline-directed medication therapies (GDMT) significantly reduce HF mortality but are challenging to implement optimally.
  • The Veterans Affairs (VA) developed a HF dashboard to enhance outpatient HF management.

Purpose of the Study:

  • To evaluate the effectiveness of proactive dashboard-directed telehealth clinics in improving GDMT use and dosing for HF patients.
  • To assess the impact of the DASH-HF intervention on medication optimization and clinical outcomes.

Main Methods:

  • A randomized, pragmatic clinical trial (DASH-HF) involving 300 veterans with heart failure with reduced ejection fraction (HFrEF) and suboptimal GDMT.
  • Intervention involved proactive dashboard-directed telehealth clinics.
  • Primary outcome was a composite score of GDMT, optimization potential score (OPS), and 6-month outcomes. Secondary outcomes included HF hospitalizations and mortality.

Main Results:

  • No significant difference in the primary outcome (OPS) between the intervention and usual care groups (2.9 vs. 2.6).
  • The intervention did not significantly reduce HF-related hospitalizations or all-cause mortality.
  • No significant improvements were observed in secondary outcomes.

Conclusions:

  • Dashboard-based clinic interventions did not improve medication optimization (OPS) or reduce hospitalizations and mortality in HF patients.
  • There is a need for better patient targeting and more intensive follow-up to enhance the utility of dashboard-based clinics for HF quality improvement.