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Related Concept Videos

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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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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Pathophysiology of Heart Failure01:17

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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...
4.5K
Renal Failure: Dose Adjustments01:11

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
575
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

520
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 IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

580
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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Related Experiment Video

Updated: Mar 29, 2026

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

Published on: June 10, 2025

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Uric Acid Variability Is Associated with Poor Prognosis in Heart Failure.

Viana Copeland1,2, Shir Elimeleh1,2,3, Assi Milwidsky1,2

  • 1The Olga and Lev Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel.

Journal of Clinical Medicine
|March 28, 2026
PubMed
Summary
This summary is machine-generated.

Serum uric acid variability, not just average levels, predicts heart failure outcomes. Low variability is linked to better survival, while high variability indicates increased mortality and hospitalization risk in heart failure patients.

Keywords:
heart failureprognosisrisk stratificationuric acid

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Area of Science:

  • Cardiology
  • Clinical Biochemistry

Background:

  • Elevated uric acid (UA) levels are associated with poor heart failure (HF) prognosis.
  • Previous research focused on mean UA levels, neglecting the impact of UA fluctuations.

Purpose of the Study:

  • To investigate the association between serum UA variability and adverse clinical outcomes in patients with heart failure.
  • To determine if UA fluctuations independently predict mortality and HF hospitalizations.

Main Methods:

  • Analysis of 18,115 heart failure patients from the SHEBAHEART registry with at least three UA measurements.
  • Quantification of UA variability using mean deviation (MD) from average UA levels, categorized into quartiles.
  • Utilized Cox regression, propensity score matching, and subgroup analyses to assess outcomes (all-cause mortality, HF hospitalization).

Main Results:

  • Over 4.3 years median follow-up, 36% experienced HF hospitalization and 65.5% died.
  • Low UA variability (Q1) was associated with reduced mortality (HR 0.79) and HF hospitalization (HR 0.84).
  • High UA variability (Q4) was linked to increased mortality (HR 1.58) and hospitalization risk (HR 1.17).

Conclusions:

  • Serum UA variability is a significant and independent predictor of mortality and HF hospitalization.
  • Serial monitoring of UA levels may improve risk stratification for heart failure management.