Body surface area and medication dosing in patients with heart failure with reduced ejection fraction |
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| Authors: | Jeremy A. Brooksbank Stephen J. Greene Tracy A. DeWald Robert J. Mentz |
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| Affiliation: | 1. Department of Medicine, Duke University Medical Center (DUMC), Box 3182, Durham, NC 27710, United States;2. Division of Cardiology, Duke University Medicial Center, Durham, NC 27710, United States;3. Duke Clinical Research Institute, 300 West Morgan Street, Durham, NC 27701, United States;4. Division of Pharmacology, Duke University Medical Center, Durham, NC 27710, United States;1. Fleury Group, Brazil;2. Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School;3. Hypertension Unit, Renal Division, University of Sao Paulo Medical School;1. Institute of Dentistry, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK;1. Cardiology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Via Aldo Moro 8, Cona, Province of Ferrara, Italy;2. Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan, Italy;3. Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna, Italy;4. Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, Province of Ferrara, Italy;1. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan;2. Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75930, United States;1. The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100 Copenhagen, Denmark;2. Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark |
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| Abstract: | Multiple medications are proven to reduce morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), but data regarding personalized approaches to optimize medication dosing remain limited. Current treatment guidelines recommend up-titration to target or maximally tolerated doses of these medications, yet use and dosing remain suboptimal in clinical practice. Body surface area (BSA) is a readily available clinical metric, used for dosing many medications, closely associated with blood pressure, renal function, and vascular congestion, and may influence efficacy, safety, and tolerability of HFrEF medications. In this review, we examine the rationale, strengths/weaknesses, and potential utility of BSA as a means of optimizing HFrEF medication use and dosing. |
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