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Exploring Advances and Challenges in Heart Failure with Stephen Greene of Duke Heart Center


In this final part of a two-part video series, Stephen Greene, MD, of Duke University School of Medicine, discussed the definition of worsening heart failure, emphasizing its four key elements: worsening signs and symptoms, chronic established heart failure, breakthrough in background therapy, and urgent escalation of therapy.

He highlighted the shift in clinical trial design, with increasing inclusion of outpatient settings and the use of worsening heart failure as a primary endpoint.

Regarding contextualizing heart failure risk, Greene expressed concern about the persisting lack of therapeutic urgency, comparing the urgency in cancer care to the insufficient attention given to heart failure. Despite effective and well-tolerated therapies, implementation remains low, contributing to avoidable hospitalizations and deaths.

Lastly, on the topic of renaming heart failure to reduce fear, Greene mentioned it’s a very popular discussion in debated circles. However, he cautioned against potential unintended consequences, emphasizing the importance of transparent communication about the condition's seriousness and the hope offered by evidence-based therapies.

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