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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 Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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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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Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
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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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Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
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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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Related Experiment Video

Updated: Jun 14, 2025

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
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Heart Failure With Reduced Ejection Fraction Polypill Implementation Strategy in India: A Convergent Parallel Mixed

Anubha Agarwal1, Raji Devarajan2, Salva Balbale3,4

  • 1Division of Cardiology, Department of Medicine and Global Health Center, Washington University in St. Louis, St. Louis, MO, USA.

Global Heart
|September 2, 2024
PubMed
Summary

A polypill strategy for heart failure with reduced ejection fraction (HFrEF) shows moderate acceptability and feasibility among Indian healthcare providers. This approach simplifies medication and may improve patient adherence, addressing key challenges in heart failure management.

Keywords:
Indiaheart failure with reduced ejection fractionmixed methods

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Last Updated: Jun 14, 2025

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Area of Science:

  • Cardiology
  • Implementation Science
  • Public Health

Background:

  • Heart failure with reduced ejection fraction (HFrEF) management globally, particularly in India, faces challenges in guideline-directed medical therapy (GDMT) adherence.
  • A polypill strategy offers a potential solution to simplify medication regimens and improve patient outcomes.

Purpose of the Study:

  • To explore physician, nurse, pharmacist, and patient perspectives on a HFrEF polypill implementation strategy in India.
  • To develop an Implementation Research Logic Model integrating quantitative and qualitative data.

Main Methods:

  • A convergent parallel mixed methods study was conducted from January 2021 to April 2021.
  • Quantitative data from stakeholder surveys (n=69) and qualitative data from key informant interviews (n=20) were integrated.

Main Results:

  • The HFrEF polypill implementation strategy demonstrated moderate acceptability (3.8/5), appropriateness (3.6/5), and feasibility (3.7/5).
  • Stakeholders identified advantages like simplified regimens and improved adherence, alongside concerns regarding side effects and medication interruption during hospitalizations.

Conclusions:

  • The HFrEF polypill implementation strategy is perceived as acceptable, feasible, and appropriate by Indian healthcare providers.
  • An Implementation Research Logic Model was developed, identifying context-specific determinants to guide future research for improving heart failure care in South Asia.