Heart Failure Guidelines and Therapy

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Questions and Answers

What is the recommended therapy that includes ACEi, ARB, ARNI, and MRA?

KDIGO

ACC

RAASi

cRAASi (correct)

What type of inhibitor is angiotensin-converting enzyme?

Renin-angiotensin-aldosterone system inhibitor

Angiotensin-converting enzyme inhibitor (correct)

Mineralocorticoid receptor antagonist

Angiotensin II receptor blocker

What is the level of evidence for the 2022 AHA/ACC/HFSA guideline?

Low-quality evidence from one or more RCTs and meta-analyses of low-quality RCTs

High-quality evidence from one or more RCTs and meta-analyses of high-quality RCTs

Moderate-quality evidence from one or more RCTs and meta-analyses of moderate-quality RCTs (correct)

Very low-quality evidence from one or more RCTs and meta-analyses of very low-quality RCTs

When can ARBs be used?

When intolerant to ACEi or ARNI Signup and view all the answers

What is the abbreviation for angiotensin receptor-neprilysin inhibitor?

ARNI Signup and view all the answers

What is the name of the receptor antagonist mentioned in the content?

Mineralocorticoid receptor antagonist Signup and view all the answers

What type of therapy is included in RAASi therapy?

ACEi, ARNI, and MRA Signup and view all the answers

What is the therapy used if a patient is intolerant to ACEi or ARNI?

ARBs Signup and view all the answers

What is the level of evidence for the recommendation in the 2022 AHA/ACC/HFSA guideline?

Moderate-quality evidence from nonrandomized studies Signup and view all the answers

What is the harm level of the recommendation in the 2022 AHA/ACC/HFSA guideline?

Risk > Benefit Signup and view all the answers

What is the purpose of the KDIGO guidelines?

To provide expert guidance on the care of patients with diabetes Signup and view all the answers

What is the class of the recommendation in the 2022 AHA/ACC/HFSA guideline?

Class 3: Harm Signup and view all the answers

What is the effect of RAASi therapy on renal K+ excretion?

It impairs renal K+ excretion. Signup and view all the answers

Which of the following medications blocks angiotensin II formation?

Direct renin inhibitor Signup and view all the answers

What is the effect of angiotensin II on aldosterone release?

It stimulates aldosterone release. Signup and view all the answers

Which of the following medications blocks aldosterone receptor binding?

Mineralocorticoid receptor antagonist Signup and view all the answers

What is the effect of RAASi therapy on urinary K+ excretion?

It impairs urinary K+ excretion. Signup and view all the answers

Which of the following medications blocks angiotensin II-mediated aldosterone release?

Angiotensin II receptor blocker Signup and view all the answers

What is the effect of aldosterone on potassium homeostasis?

It enhances potassium excretion. Signup and view all the answers

Which of the following medications impairs renal K+ excretion?

All of the above Signup and view all the answers

What is the effect of hyperkalemia on RAASi therapy?

It impairs RAASi therapy. Signup and view all the answers

Which of the following medications blocks the effect of angiotensin II on aldosterone release?

Angiotensin II receptor blocker Signup and view all the answers

Study Notes

RAASi Therapy and Heart Failure

RAASi therapy includes ACEi, ARNI, and MRA.
ARBs can be used if intolerant to ACEi or ARNI.

Guidelines and Recommendations

2022 AHA/ACC/HFSA guideline: Recommendation (3:Harm B-NR) suggests that RAASi therapy may harm patients with CKD.
2022 AHA/ACC/HFSA guideline: Recommendation (2b B-R) suggests that ARBs can be used if intolerant to ACEi or ARNI.

RAAS Inhibition and Hyperkalaemia

RAAS inhibition impairs renal K+ excretion.
Direct renin inhibitors and ACEi block angiotensin II formation, leading to impaired aldosterone release and hyperkalaemia.
ARBs block angiotensin II-mediated aldosterone release, leading to hyperkalaemia.
MRAs block aldosterone receptor binding, leading to hyperkalaemia.

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Description

This quiz covers the guidelines and therapies for heart failure, including RAASi therapy, ARBs, and potassium-lowering agents, as recommended by the 2022 AHA/ACC/HFSA guideline.