Abdominal venous congestion is increasingly recognized as an important contributor to clinical deterioration in acute decompensated heart failure (ADHF). Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) may provide complementary insights into systemic congestion and organ perfusion; however, their prognostic value in ADHF remains undefined. To evaluate the prognostic value of IAP and APP in patients with acute decompensated heart failure. This prospective observational study enrolled 110 consecutive patients hospitalized with ADHF. IAP was measured using a standardized transvesical technique within the first 24 h of admission, and intra-abdominal hypertension (IAH) was defined as an IAP ≥ 12 mmHg. APP was calculated as mean arterial pressure minus IAP. Clinical, echocardiographic, and laboratory characteristics were recorded. Mortality and rehospitalization at 1, 6, and 12 months were assessed, and multivariable regression analyses were performed to identify independent predictors of adverse outcomes. IAH was present in 29.1

BACKGROUND:The HFA-PEFF and H2FPEF scores are widely used for diagnosing heart failure with preserved ejection fraction (HFpEF). However, HFpEF is a heterogeneous condition with multiple phenotypes influenced by comorbidities and etiologies. OBJECTIVES:This study aimed to evaluate the performance and agreement of these scoring systems across different HFpEF phenotypes and identify additional echocardiographic and clinical parameters that may improve phenotyping. METHODS:A total of 194 HFpEF patients were classified into three phenotypes: (1) common metabolic group, (2) atrial fibrillation (AF)-predominant group, and (3) hypertension with left ventricular hypertrophy group. The clinical, laboratory, and echocardiographic characteristics of these phenotypes were analyzed. The agreement and performance between HFA-PEFF and H2FPEF scores for phenotypes in HFpEF patients were assessed. RESULTS:A total of 194 HFpEF patients were included. While 92.3% of patients had a high HFA-PEFF score, only 42.8% had a high H2FPEF score. The agreement between these scoring methods was low across all phenotypes. Phenotype-specific differences were observed: interventricular septal thickness was highest in phenotype 3, systolic pulmonary artery pressure (SPAP) was highest in phenotype 2, and left atrial reservoir strain (LASr) and right ventricular free wall longitudinal strain (RV-FWLS) were lowest in phenotype 2. CONCLUSION:The HFA-PEFF and H2FPEF scores showed limited agreement in distinguishing HFpEF phenotypes. Additional echocardiographic parameters such as IVS thickness, SPAP, LASr, and RV-FWLS may enhance phenotypic differentiation and improve HFpEF classification. A more refined diagnostic approach incorporating these parameters could guide personalized treatment strategies.

Functional exercise capacity is affected in patients with Atrial fibrillation (AF). Although the six-minute walk test (6MWT) is widely used to assess functional capacity, it requires a long corridor and time. Recently, the one-minute sit-to-stand test (1STST), a popular test in the cardiovascular patient population, assesses functional impairment in AF. This study aimed to compare threshold values of the 1STST that can be used to differentiate functional impairment associated with mortality in AF. Forty-five patients with AF participated in this study. Demographic and clinical characteristics were recorded. Functional exercise capacity was evaluated using the 1STST and 6MWT. Quality of life (QoL) was assessed with the Atrial Fibrillation Impact Questionnaire (AF Impact). A threshold for the 1STST to identify functional impairment based on different cut-offs of the 6MWT (≤200 m and ≤380 m) was determined using a receiver operating characteristics (ROC) curve analysis. The cut-off point for the 1STST was determined as 13 repetitions for ≤200m cut-off of the 6MWT (sensitivity: 100 %, specificity: 84.6 %; AUC:0.94; 95% CI 0.82 to 0.98; p<0.001). For the ≤380 m cut-off of the 6MWT, the threshold of the 1STST was identified as 15 repetitions (sensitivity: 71.43 %, specificity: 100.00 %; AUC:0.87; 95% CI 0.73 to 0.95; p<0.001). Two AUCs showed similar excellent discrimination (AUCs =0.812 for ≤ 380 m; AUCs = 0.901 for ≤ 200 m; p=0.268). Also, patients with AF below the cut-off point of 13 repetitions (%42.22) had lower QoL, functional capacity and change in heart rate during the test (p<0.05). In patients with AF, a cut-off of 13 repetitions in the 1STST was superior to 15 repetitions in detecting functional impairment associated with mortality. Patients with less than 13 repetitions had worse quality of life and functional levels. Therefore, this threshold of the 1STST can be used to predict these outcomes in clinical practice.

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease characterized by extracellular deposition of amyloid fibrils. Tafamidis is currently the only approved pharmacologic therapy for ATTR-CM, with proven efficacy in clinical trials. However, real-world data, particularly from Türkiye, remain limited. This study aimed to assess the clinical characteristics, treatment responses, and outcomes of patients with ATTR-CM receiving tafamidis in real-world single-center Turkish patients. This was a retrospective, single center, observational study including 13 patients diagnosed with ATTR-CM. Demographic, clinical, echocardiographic, laboratory, and follow-up data were collected. Tafamidis usage, tolerance, and long-term outcomes including mortality, heart failure hospitalization, and biomarker trends were analyzed. Among 13 patients (mean age: 71.4 ±12.2 years; 53.8% male), 8 had ATTRwt and 5 had ATTRv. At baseline, 69.2% were NYHA Class III. The mean treatment duration was 21.6 ±10.4 months. At one year, 92.3% of patients remained on therapy; by year three, five patients had died (38.5%), mostly due to heart failure. Patients who died were older (79 ±6.4 vs. 66.6 ±12.0 years, p=0.035), had worse baseline NYHA class (p=0.033), higher sPAP (p=0.045), and reduced LA reservoir strain (p=0.046). NT-proBNP decreased in 23.1% of patients during the first year, predominantly in those with ATTRv. Tafamidis was generally well tolerated. This single-center real-world study from Türkiye offers valuable insights into tafamidis use in ATTR-CM, highlighting the prognostic relevance of early diagnosis and baseline functional status, and supporting its feasibility, tolerability, and potential clinical benefit in routine care despite the small sample size.

INTRODUCTION:Graves' disease is associated with cardiovascular alterations. Data on the left ventricular (LV) function and left atrial (LA) mechanics in Graves' disease remain limited. This study investigated the relationship between disease duration and myocardial deformation parameters, including LA strain and LV global longitudinal strain (LV-GLS). METHODS:In this cross-sectional study, 90 patients with Graves' disease underwent comprehensive echocardiographic assessment. Disease duration was classified as short (≤2 years) or long (>2 years) based on receiver operating characteristic analysis. LA reservoir strain (LASr), conduit strain (LAScd), contractile strain (LASct), and LV-GLS were measured. In addition, strain parameters were compared between patients according to thyroid status (euthyroid vs. hyperthyroid). RESULTS:Patients with longer disease duration showed significantly reduced LASr (36.9 ± 12.0% vs. 46.3 ± 11.0%, p = 0.001), LAScd (-20.2 ± 9.3% vs. -26.3 ± 9.4%, p = 0.007), LASct (-17.0 ± 6.4% vs. -19.9 ± 5.9%, p = 0.045), and absolute LV-GLS (20.8% [18.4%-24.9%] vs. 24.3% [21.7%-27.4%], p = 0.007). Disease duration correlated negatively with LASr (r = -0.340, p < 0.001) and absolute LV-GLS (r = -0.311, p = 0.003). Multivariate analysis identified LASr (OR = 0.947, p = 0.017) and LV-GLS (OR = 0.838, p = 0.020) as independent predictors of prolonged disease duration. In euthyroid patients with longer disease duration, strain parameters were significantly lower than in hyperthyroid patients with shorter duration. CONCLUSION:Longer Graves' disease duration is associated with progressive subclinical impairment of atrial and ventricular mechanics, with strain abnormalities evident even in euthyroid patients. These findings highlight the cumulative impact of disease chronicity and support the use of speckle-tracking echocardiography for early detection of myocardial dysfunction and closer cardiovascular monitoring in this population.

Hyperkalaemia (HK; serum potassium [K+] level >5.0 mmol/L) is common in people with chronic kidney disease (CKD) or heart failure (HF), often due to renal impairment and the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which slow disease progression and improve outcomes. The prevalence and impact of HK in the Middle East and Africa (MEA) are poorly understood, complicating management due to high rates of CKD and HF driven by diabetes, hypertension (HTN), and cardiovascular disease. Our study utilizes data from iCaReMe Global Registry (NCT03549754) to address this gap by assessing HK prevalence and risk factors in patients with CKD and HF in the MEA region. This cross-sectional observational study included adult subjects with CKD or HF enrolled in the iCaReMe Registry from 11 MEA countries (Egypt, Ethiopia, Ghana, Iraq, Jordan, Kenya, Lebanon, Nigeria, South Africa, Türkiye, United Arab Emirates). Demographic and clinical characteristics, HK prevalence, and treatment patterns were summarized descriptively. HK risk factors were analysed using stepwise logistic regression. A total of 5,596 adults (mean age 57.3 ± 14.0 years; 57.3% male) were included, with 3,574 individuals (63.9%) having CKD (mean estimated glomerular filtration rate [eGFR] 35.4 ± 26.4 mL/min/1.73 m2) and 2,797 individuals (50.0%) having HF (mean left ventricular ejection fraction 39.0 ± 13.5%). HTN was present in 78.0% of participants and 50.8% had type 2 diabetes mellitus. Mean serum K+ was 4.5 ± 0.7 mmol/L, with an overall HK prevalence of 17.6% (23.0% in those with CKD and 10.5% in HF patients). Overall, 62.4% of patients were on angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or angiotensin receptor-neprilysin inhibitors, 38.4% on loop diuretics, 30.5% on sodium-glucose co-transporter 2 inhibitors, and 25.7% on mineralocorticoid receptor antagonists. Patients with HK (mean K+ = 5.5 ±0.5 mmol/L) exhibited decreased kidney function with more advanced CKD stages (78.3% of subjects with G3b–G5 stage) and lower RAASi use than non-HK patients (mean K+ = 4.3±0.5 mmol/L). Only 10.3% of those with HK were on anti-HK therapies, with 40% receiving potassium binders. Multivariate analysis revealed that RAASi use (odds ratio [OR], 1.5; 95% CI, 1.2–1.9; P = 0.0026) and serum creatinine levels (mg/dL) (OR, 1.1; 95% CI, 1.0− 1.1; P = 0.0217) were positively associated with HK. This study offers insights into the burden and risk factors of HK in patients with CKD and HF in the MEA region. The findings reveal a substantial prevalence of HK, especially in advanced CKD, along with suboptimal use of RAASi and low utilization of anti-HK therapies. These gaps highlight the need to align real-world practices with guidelines by optimizing RAASi use while managing HK risks. Improving access to novel potassium binders and implementing region-specific strategies could improve outcomes for this high-risk population.

BACKGROUND:Heart failure with preserved ejection fraction (HFpEF) accounts for a significant proportion of heart failure cases and is associated with high morbidity and mortality. While echocardiography plays a central role in HFpEF assessment, the prognostic value of electrocardiographic (ECG) findings, particularly in lead aVR, remains underexplored. This study investigates the relationship between a positive T wave in lead aVR (TaVR) and left atrial (LA) and left ventricular (LV) function, as well as its prognostic significance in HFpEF patients. METHODS:This retrospective study included 231 HFpEF patients diagnosed according to ESC guidelines. Patients underwent comprehensive echocardiography and 12‑lead ECG evaluation. Positive TaVR was defined as a T-wave amplitude ≥1 mm in lead aVR. LA and LV functions were assessed using LA reservoir strain (LASr) and LV global longitudinal strain (GLS), respectively. Multivariate Cox regression and Kaplan-Meier survival analyses were performed to evaluate the prognostic significance of TaVR. RESULTS:Positive TaVR was observed in 34.6 % of patients and was associated with impaired LASr (15.02 ± 6.65 % vs. 17.78 ± 9.10 %, p = 0.023) and LV GLS (-13.66 ± 3.49 % vs. -15.19 ± 3.02 %, p = 0.001). Positive TaVR independently predicted 1-year all-cause mortality (HR = 6.02, p < 0.001) and 6-month all-cause mortality (HR = 9.67, p < 0.001). Patients with positive TaVR had higher hospitalization rates and worse clinical outcomes. CONCLUSION:Positive TaVR is associated with LA dysfunction, LV remodeling, and poor prognosis in HFpEF. Incorporating this ECG parameter into routine clinical assessments could enhance risk stratification and guide management strategies for HFpEF patients.

Heart failure (HF) is a complex clinical condition associated with significant morbidity and mortality. Early diagnosis and effective management at the primary care level are essential for improving patient outcomes and reducing the burden on the healthcare systems. The Eurasian Society of HF and the Turkish Association of Family Medicine developed a guideline that underscores the critical role of natriuretic peptides (NPs) in the early detection, diagnosis, and management of HF. NPs, particularly the N-terminal pro-B-type NP, are a reliable biomarker for identifying HF, guiding treatment decisions, and monitoring disease progression. This guideline emphasizes the importance of measuring the levels of these peptides in primary care so as to detect individuals at risk, confirm the diagnosis of HF in symptomatic patients, and evaluate the treatment response. The recommended thresholds for NP levels account for variations arising from factors such as age, gender, and the presence of other health conditions. B-type natriuretic peptides (BNP) levels ≥ 35 pg/ml or N-terminus-proBNP levels ≥ 125 pg/ml are used to confirm the likelihood of HF in symptomatic patients, enabling timely diagnosis and appropriate intervention. Incorporating NP testing into routine clinical practice enables timely referrals and ensures appropriate management at all stages of HF. Beyond diagnosis, the measurement of NPs provides valuable information about treatment effectiveness and prognosis, allowing clinicians to individualize the treatment. By integrating NP testing into primary care, healthcare providers can facilitate early detection, optimize treatment strategies, and improve the quality of life for patients with or at risk of HF. Thus, this guideline highlights the essential role of primary care physicians in addressing the growing challenges of HF through the effective and evidence-based use of NPs.

BACKGROUND:Cardiac amyloidosis (CA) is an increasingly recognized disease. Several recent advanced imaging techniques and parameters have been introduced into the diagnosis of CA. However, the first step in using those techniques is clinical suspicion. Left ventricular hypertrophy (LVH) is the main entity in rising the suspicion of CA in routine echocardiography, although it is not a diagnosis for CA. The aim of this study is to investigate the prevalence of CA and its subtypes and predictive value of clinical and echocardiographic red flags of CA among consecutive adult patients with LVH identified during routine echocardiographic examination in 25 tertiary institutions in Türkiye. METHODS:This was a prospective observational multicenter, national registration study. Patients with LVH (interventricular septum thickness ≥13 mm or >15 mm in those with hypertension) were screened for CA stepwise. The first step was a clinical questionnaire for the red flags of CA. Those having ≥2 red flags were further analyzed by detailed echocardiography, blood tests, Tc-pyrophosphate (PYP) bone scintigraphy, and histopathological examination if needed. Parameters associated with CA were evaluated via univariate and multivariate analyses. Wild-type transthyretin (wTTR) vs. mutant-type TTR (mTTR), CA discriminators were also evaluated in the same manner. RESULTS:A total of 420 patients meeting these criteria were included in the study. With a standardized algorithmic approach, 27.1% (114) of patients received a CA diagnosis. Among these patients with CA, 50.8% (58) were diagnosed with immunoglobulin free chain (AL) CA, 38.6% (44) with wTTR CA, and 7% (8) with mTTR CA. Left ventricular apical sparing pattern and restrictive type LV filling on echocardiography, low QRS voltage on ECG, bilateral carpal tunnel syndrome, low blood pressure, right ventricular diameter, and an increased basal heart rate (HR) were independent predictors for CA diagnosis. When it comes to diagnosis of wTTR CA; advanced age (age >75), lower troponin values, absence of pericardial effusion and absence of proteinuria were the independent predictors. CONCLUSION:Cardiac amyloidosis is highly prevalent in a patient population with LVH and 2 red flags who underwent a standardized algorithmic approach, in which apical sparing, restrictive filling pattern, low QRS voltage, carpal tunnel syndrome, low blood pressure, and increased HR are the highly suggestive signs of CA. Among this pool of newly diagnosed CA patients in Türkiye, AL-CA constituted 50.8%, wTTR CA 38.6%, and mTTR CA 7%, emphasizing that approximately 1 in 2 patients diagnosed with CA may have TTR CA.

Background/aim:Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests. The aim of this study was to review the diagnostic approach to HF in Türkiye. Materials and methods:This study is a subanalysis of the nationwide TRends-HF study, based on anonymized data from National Electronic Database between January 1, 2016, and December 31, 2022. Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported. Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels, and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR], etc.) during the initial diagnosis and/or follow-up of HF patients, were obtained from the National Electronic Database. The diagnostic test usage rates were analyzed according to years, geographical regions, and socioeconomic regions of Türkiye. Results:The study population consisted of 2,722,151 HF patients (51.7% female, mean age 68.33 ± 14.01 years). All HF patients had at least one electrocardiogram and one TTE examination, and all underwent routine biochemical tests at least once during the follow-up period. CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%. Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3% of patients, respectively. Among all Turkish HF patients, 16.3% had at least one NP measurement. The highest rate of NP use was observed in the Central Anatolia Region (21.0%), while the lowest rate was in the Aegean Region (11.7%). NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021). Conclusion:The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Türkiye. However, detailed laboratory tests and advanced imaging methods are not utilized sufficiently, which could lead to issues in patient management.

Background/aim:Despite Türkiye's relatively young population, there is an emerging trend of earlier diagnoses of chronic diseases, including heart failure (HF). This study aims to shed light on survival rates, potential influences of guideline-directed therapies, and sex-based differences necessitating personalized management in HF. Materials and methods:We conducted a nationwide retrospective cohort analysis of 2,722,151 patients with HF using deidentified data from the Turkish Ministry of Health's national electronic database. That cohort included 2,701,099 adult patients with HF. Adult patients were divided into two groups based on their outcomes as those who were deceased and those who survived and were then compared. Multivariate regression analysis was conducted to identify variables predicting mortality. The patients' hospital admissions and length of hospital stay were analyzed based on survival status and age. Results:Out of 2,722,151 HF patients, the overall mortality rate was 33.7%, with a difference observed according to sex (32.5% in female patients, 35.0% in male patients). Survival rates at 1, 5, and 7 years after the HF diagnosis were detailed. Deceased HF patients had more comorbidities, higher natriuretic peptides, and lower glomerular filtration rates. Hospitalization patterns varied, with 41% experiencing no hospitalization. The average length of hospital stay in 2022 was 6 days, with sex- and age-specific disparities. Conclusion:The survival rate of HF in Türkiye is similar to world data. The survival of female patients is better than that of male patients. Increased survival rates can likely be attributed to the widespread use of guideline-directed therapies. Finally, high healthcare utilization is observed, especially in emergency situations.

Background/aim:The epidemiological data on heart failure (HF) vary between regions within the same country. We aimed to investigate the epidemiological data on HF in Türkiye across all age groups regarding seven geographical regions. Materials and methods:We included all patients from the Turkish population who received a first diagnosis of HF between January 1, 2016 and December 31, 2022, using ICD-10 codes from the National Electronic Healthcare Database. The data were categorized by seven geographical regions of Türkiye. Results:The median age of index diagnosis of HF was 70 (60-78) years in all age groups and 4 (1-12) years in pediatric population. The prevalence rate of HF was the highest in the Black Sea Region at 3.103%, while the Southeastern Anatolia Region exhibited the lowest at 1.436%. In all age groups, female patients with HF were older and had a higher prevalence rate across all geographical regions than male patients. From 2017 to 2021, incidence rates of HF declined to 3.0 per 1000 person years, with a consistent decrease for each geographical region. The highest incidence rates of HF were seen in the Black Sea Region, while the Southeastern Anatolia Region had the lowest. Evaluating pediatric population with HF, prevalence of HF was 0.81 per 1000 people (female children: 0.77 per 1000 people, male children: 0.84 per 1000 people). Female children with HF demonstrated the highest prevalence in the Central Anatolia Region with a rate of 1.04 per 1000 people, while male pediatric population with HF exhibited the greatest prevalence of HF in the Mediterranean Region, reaching 0.89 per 1000 people. The lowest prevalence of children with HF in both sexes was observed in the Eastern Anatolia Region (female children: 0.62 per 1000 people, male children: 0.48 per 1000 people). Conclusion:Despite regional variations, prevalence of HF in Türkiye's regions aligns with global trends. Sex-based differences in HF prevalence were evident across all age groups, including pediatric population. Incidence rates of HF in each region exhibited a substantial decline by 2021.

Background: Given the increased risk of falls in patients with heart failure (HF), there is limited information in the literature about the possible relationship between fall risk and functional capacity. Objective: To investigate the relationship between functional capacity and fall risk in patients with HF and to determine whether there are differences in clinical parameters between patients with and without fall risk. Methods: The study included 64 patients with HF. The Activity-Specific Balance Confidence Scale (ABC) determined the fall risk. Functional capacity was assessed with the 6-minute walk test (6MWT). The Berg Balance Scale (BBS), the timed up-and-go test (TUG), and the five times sit-to-stand (5-STS) test were used to evaluate functional balance and mobility. Comorbidities and dyspnea perception were assessed with the Charlson Comorbidity Index (CCI) and modified Medical Research Council (mMRC), respectively. Results: The 6MWT was associated with fall risk in logistic regression with an odds ratio of 0.979 (0.970-0.989, p < 0.001). Furthermore, the 6MWT had a discriminative value for increased fall risk in patients with HF, with a cutoff value of 248 m. Patients with increased fall risk had lower 6MWT distance, BBS, and gait speed, and higher CCI and mMRC, number of falls, duration of TUG and 5STS compared to patients with no increased fall risk (p < 0.05). Conclusions: The study results demonstrated that 6MWT may be a clinically useful tool in quickly identifying potential balance problems and increased fall risk by providing insight into fall risk/balance confidence in addition to assessing functional capacity.

Background Although there have been significant improvements in the treatment of heart failure (HF) in recent decades, its prognosis remains poor. Although there are many biomarkers that can help predict the prognosis of patients with HF, there is a need for simpler, cheaper, and more easily available biomarkers. Objective To evaluate the predictive value of pan-immune-inflammation value (PIV) in patients with acute decompensated HF. Methods We analyzed 409 patients with HF with reduced ejection fraction who were hospitalized for acute decompensated HF. Patients were divided into 3 groups according to tertiles of PIV: tertile 1 (PIV < 357.25), tertile 2 (PIV ≥ 357.25 and < 834.55), and tertile 3 (PIV ≥ 834.55). P values < 0.05 were considered statistically significant. Kaplan-Meier curves and Cox proportional hazards regression models were used to evaluate the association between PIV and all-cause mortality. The primary outcome was 5-year all-cause mortality, and the secondary outcomes were in-hospital 30 days,, 180-day, and 1-year all-cause mortality. Results We showed that higher PIV value was associated with both primary and secondary outcomes. The Kaplan-Meier curve showed that patients with higher PIV values had an increased risk of short- and long-term all-cause mortality (log-rank p < 0.001). In the multivariate analysis, PIV was identified as an independent predictor of long-term all-cause mortality in patients with acute decompensated HF, and we observed a 1.96-fold increase in the hazard of an event (odds ratio: 1.96, 95% confidence interval: 1.330 to 2.908, p = 0.001). Conclusions Our study showed that the novel biomarker PIV can be used as a predictor of prognosis in patients with acute decompensated HF.

Heart failure (HF) remains a serious health and socioeconomic problem in the Middle East and Africa (MEA). The age-standardized prevalence rate for HF in the MEA region is higher compared to countries in Eastern Europe, Latin America, and Southeast Asia. Also cardiovascular-related deaths remain high compared to their global counterparts. Moreover, in MEA, 66% of HF readmissions are elicited by potentially preventable factors, including delay in seeking medical attention, nonadherence to HF medication, suboptimal discharge planning, inadequate follow-up, and poor social support. Patient support in the form of activation, counseling, and caregiver education has been shown to improve outcomes in patients with HF. A multidisciplinary meeting with experts from different countries across the MEA region was convened to identify the current gaps and unmet needs for patient support for HF in the region. The panel provided insights into the real-world challenges in HF patient support and contributed strategic recommendations for optimizing HF care.

Objective: The aim of this study was to analyze the role of various B-blockers in managing exercise-induced blood pressure escalations, referred to as exaggerated blood pressure response (eBPR). Despite the importance of this phenomenon, there is limited data on the efficacy of B-blockers in controlling eBPR. Method: Our retrospective cohort for this study comprised 2,803 individuals who underwent treadmill tests from January 2016 to February 2018. A further subgroup analysis of 1,258 patients receiving B-blocker treatment was performed to evaluate the influence of different B-blockers on eBPR.