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Related Concept Videos

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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Heart Failure Drugs: β-Blockers01:22

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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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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: 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 Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

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Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
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Updated: May 13, 2025

Author Spotlight: Exercise Test for Evaluation of the Functional Efficacy of the Pig Cardiovascular System
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Patient-Reported Outcomes as End Points in Heart Failure Trials.

Javed Butler1,2, Muhammad Shariq Usman3,4, Charu Gandotra5

  • 1Baylor Scott and White Research Institute, Baylor Scott and White Health, Dallas, TX (J.B.).

Circulation
|April 14, 2025
PubMed
Summary
This summary is machine-generated.

Patient-reported outcomes (PROs) are crucial for heart failure care, but interpreting trial results is challenging. This article discusses issues with PRO assessment and analysis to improve their use in research and clinical practice.

Keywords:
United States Food and Drug Administrationhealth statusheart failurepatient reported outcome measuresquality of life

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Area of Science:

  • Cardiology
  • Clinical Research
  • Health Outcomes

Background:

  • Heart failure affects millions globally, with increasing recognition of patient-reported outcomes (PROs) alongside traditional metrics like hospitalization and mortality.
  • Regulatory agencies and professional societies acknowledge PROs, yet their interpretation in heart failure trials remains difficult due to inconsistent methodology.
  • Challenges include lack of consensus on PRO assessment timing/frequency and defining minimal clinically important differences.

Purpose of the Study:

  • To address the difficulties in interpreting PRO data in heart failure clinical trials.
  • To discuss challenges related to PRO assessment, minimal clinically important differences, and analytical methods.
  • To facilitate the effective use of PROs in heart failure research, regulatory evaluations, and clinical practice.

Main Methods:

  • In-depth discussion of issues surrounding PRO assessment and analysis in heart failure.
  • Utilizes the Kansas City Cardiomyopathy Questionnaire (KCCQ) as a specific example.
  • Critiques traditional analysis methods like mean differences and responder analysis for statistical limitations.

Main Results:

  • Current methods for assessing and analyzing PROs in heart failure trials are often difficult to interpret.
  • Lack of standardized protocols for PRO assessment timing and frequency hinders consistent data collection.
  • Establishing minimal clinically important differences for PROs remains a significant challenge.

Conclusions:

  • Standardizing PRO assessment and analysis is essential for reliable interpretation in heart failure research.
  • Addressing methodological challenges will enhance the utility of PROs for evaluating interventions and guiding clinical decisions.
  • Improved PRO utilization can lead to better patient-centered care in heart failure management.