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Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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

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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

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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: 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 IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

317
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: 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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Related Experiment Video

Updated: Jan 14, 2026

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
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Comparing High- Versus Low-Dose Entresto in Heart Failure Patients: A 2025 Meta-Analysis.

Akshay Maharaj1, Sajay Bidhesi2, Sheneel Jaggernauth3

  • 1Internal Medicine, Port of Spain General Hospital, Port of Spain, TTO.

Cureus
|October 17, 2025
PubMed
Summary
This summary is machine-generated.

Higher doses of Entresto (sacubitril/valsartan) did not significantly improve left ventricular ejection fraction (LVEF) in heart failure patients. However, high-dose Entresto showed a significant reduction in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels.

Keywords:
angiotensin receptor blocker (arb)angiotensin receptor-neprilysin inhibitorcardiology researchentrestoheart failure with reduced ejection fractioninternal medicine-cardiologysacubitril-valsartan

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Area of Science:

  • Cardiology and Cardiovascular Research
  • Pharmacology and Therapeutics
  • Clinical Trial Analysis

Background:

  • Entresto (sacubitril/valsartan) is a key treatment for heart failure with reduced ejection fraction (HFrEF).
  • Its efficacy across different dosages requires further investigation to optimize patient outcomes.
  • Understanding dose-response relationships is crucial for refining HFrEF management strategies.

Purpose of the Study:

  • To compare the effectiveness of high-dose versus low-dose Entresto in patients with chronic heart failure.
  • To evaluate the impact of different Entresto dosages on key cardiovascular outcomes.
  • To synthesize evidence from randomized controlled trials through meta-analysis.

Main Methods:

  • Systematic literature search of PubMed, ClinicalTrials, and Cochrane databases.
  • Meta-analysis of nine randomized controlled trials involving 4,011 patients with HFrEF.
  • Primary outcomes included heart failure hospitalization, mortality, LVEF, NT-proBNP, NYHA class, and blood pressure.

Main Results:

  • No statistically significant difference in left ventricular ejection fraction (LVEF) improvement between low- and high-dose Entresto groups.
  • A statistically significant reduction in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels was observed with higher Entresto doses.
  • Higher Entresto dosage was associated with greater NT-proBNP reduction, suggesting improved cardiac stress and function.

Conclusions:

  • High-dose Entresto does not offer significant LVEF benefits over lower doses but effectively reduces NT-proBNP levels.
  • Findings support potential dose-dependent benefits of Entresto in managing HFrEF, particularly concerning cardiac stress markers.
  • Further large-scale studies are needed to confirm long-term clinical impacts and optimize Entresto dosing strategies.