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Clinical Trials: Hypertension/High Blood Pressure
IRB No. 19-105-1 (Dr. Sara Tabtabai, PI): Guideline Directed Medication Titration Program in Patients with Heart Failure with reduced Ejection Fraction
A patient newly diagnosed with heart failure with reduced ejection fraction requires close follow up for titration of medications as blood pressure, electrolytes and symptoms permit. Although the benefits of guideline directed medical therapy (GDMT) have been well studied, there remains a significant gap in the receipt of GDMT in the ambulatory and hospitalized setting. As such, we seek to assess the utility of focused GDMT clinic to reduce this gap. We hypothesize that implementation of a GDMT focused clinic will reduce the gap, improve medication compliance and in turn, improve the mean ejection fraction, and reduce hospitalization rates.
IRB No. 22-144-1 (Dr. Agnes Kim, PI): Echocardiographic Assessment of Pulmonary Artery Pressures
Pulmonary hypertension (PHT) is a complex and challenging hemodynamic condition which is characterized by pathologic increase in mean Pulmonary Arterial Pressure (mPAP) >20 mm of Hg at rest.1 The elevated pulmonary pressures could be due to a variety of underlying causes such as lung disease, left heart disease or disease affecting small pulmonary vessels. The gold standard for a definitive diagnosis of PHT is a right heart catheterization (RHC), done invasively to assess filling pressures.2 Nevertheless, immense improvement in the technology over last few decades has made the noninvasive quantification of pulmonary pressures with increased sensitivity possible by transthoracic echocardiography (TTE).2 Echocardiography, is currently the first imaging modality in patients where PHT is suspected. It not only estimates the systolic pulmonary arterial pressures, but also provides useful information on right ventricle function, left ventricle systolic and diastolic function, as well as valvular disease that might be contributing the elevated pulmonary pressures.3 The goal is to assess the accuracy of mPAP calculated through echocardiographic assessment of PVAT and mPAP obtained through RHC.