Enhanced Growth Hormone and IGF-1 Axis Modulation in Chronic Heart Failure: A Multicenter, Double-Blind, Placebo-Controlled Study
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Abstract
Atrial fibrillation (AF) in chronic heart failure (CHF) presents unique challenges for heart rate management, with current evidence suggesting that traditional heart rate control strategies may not improve survival outcomes in this cohort as they do in patients with sinus rhythm (SR). This study aims to advance understanding by investigating personalized and adaptive heart rate management strategies tailored to CHF patients with AF. We propose a randomized controlled trial to compare individualized heart rate control—guided by patient-specific biomarkers, autonomic nervous system assessment, and heart rate variability (HRV) monitoring—with conventional heart rate management. Additionally, this study will examine the impact of real-time, multimodal monitoring via wearable devices, allowing dynamic adjustments to heart rate control based on patient response. A cohort of CHF patients with AF will undergo continuous HRV and rhythm monitoring, coupled with regular biomarker evaluations, to assess correlations between heart rate dynamics and survival. Advanced pharmacological (e.g., ivabradine) and device-based therapies (e.g., implantable cardioverter-defibrillators) will be integrated to evaluate their roles in enhancing heart rate management outcomes. We hypothesize that this personalized, real-time approach will reduce mortality, improve quality of life, and provide insights into the pathophysiological differences that underlie heart rate impacts in AF versus SR in CHF. This study could shift current paradigms in CHF management, promoting a precision-medicine approach to heart rate control for AF patients with heart failure.JRCD 2021; 4(5): 109–114
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References
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