Heart Failure Congress 2024 Forum - Recent Posts

RE: How to best address clinical inertia ?

Zaur Gasimov — Fri, 08 Sep 2023 09:21:16 +0000

@hfc-admin Awaiting moderation04/09/2023 11:12 am Avatar Zaur Gasimov (@Zaur Gasimov) Guest New Member 0 Posts 0 0 0 The best window of optimize treatment is inpatiient period,immediately after relief symthoms of acute heart failure .even for some new medications it is possible to begin in acute setting,for instance SGLT2 inh.do not impact blood pressure significantly and from my point of view looks like drugs which can be used as "fire and do not worry".In generally all drugs were prescribed in hospital in acute phase associates in pts with relief of symptoms,therefore patient likely will be more adherent to the medicines were prescribed in a hospital.But in generally,the best window to optimize therapy is everytime in meaning that for to reach GDMT goal we have to be in contact with patient as often as possible.

Answer to: How to best address clinical inertia ?

Zaur Gasimov — Mon, 04 Sep 2023 11:21:31 +0000

I think that question "How to best address clinical inertia ?" : should to be substitute to the question "Why we cannot to reach the level of adherence and low level of inertia observed in R...

Answer to: In the HF patient journey, when is the best window of opportunity to optimize therapy ?

Zaur Gasimov — Mon, 04 Sep 2023 11:12:15 +0000

The best window of optimize treatment is inpatiient period,immediately after relief symthoms of acute heart failure .even for some new medications it is possible to begin in acute setting,for instance SGLT2 inh.do not impact blood pressure significantly and from my point of view looks like drugs which can be used as "fire and do not worry".In generally all drugs were prescribed in hospital in acute phase associates in pts with relief of symptoms,therefore patient likely will be more adherent to the medicines were prescribed in a hospital.But in generally,the best window to optimize therapy is everytime in meaning that for to reach GDMT goal we have to be in contact with patient as often as possible.

Answer to: How do you think the 4 pillar medications recommended in guidelines should be used ? one after the other ? The 4 together from the start ?

Rafiu Adefila — Thu, 03 Aug 2023 19:06:42 +0000

I think the patient’s clinical state should determine how GDMT should be initiated. Two important factors will be the blood pressure and the patient’s eGFR. For example, if the patient has non-ischemic CMP with severe LV dysfunction and low-normal BP (e.g., 95/60mmHg), I won’t be in a hurry to initiate ARNI/ACEI/ARB. MRA and SGLT2i have less effect on BP in heart failure patients. I will also commence such patients on a low dose beta blocker, slowly titrated up. My approach will differ in a patient with better BP profile who has other contraindication to these 4 meds. For such, the 4 pillars can be initiated at a go. Of course, SGLT2i should not be prescribed in patients with very low eGFR or on dialysis.

Answer to: How do you think the 4 pillar medications recommended in guidelines should be used ? one after the other ? The 4 together from the start ?

PEDRO FORCADA — Wed, 12 Jul 2023 09:47:10 +0000

SHOULD BE USED ONE AFTER THE OTHER ACCORDING TO THE CLINICAL STAGE AND TESTING TOLERANCE AND CLINICAL RESPONSE

How do you think the 4 pillar medications recommended in guidelines should be used ? one after the other ? The 4 together from the start ?

RytTrack — Thu, 01 Jun 2023 11:02:00 +0000

Explain in detail.

How to best address clinical inertia ?

RytTrack — Thu, 01 Jun 2023 11:00:23 +0000

Discuss the process.

In the HF patient journey, when is the best window of opportunity to optimize therapy ?

RytTrack — Thu, 01 Jun 2023 10:58:25 +0000

Discuss in detail.