Success with Heart Failure:
New Strategies to Reverse
Acute Decompensation


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  1. The most frequent reason for heart failure hospitalization relates to hemodynamic decompensation and volume overload.
    True
    False

  2. Which of the following neurohumoral systems are activated in heart failure?
    Renin-angiotensin-aldosterone system
    Sympathetic nervous system
    Endothelin system
    All of the above

  3. The focus of heart failure therapy is on symptom relief, rather than altering the underlying
    pathophysiology.
    True
    False

  4. Which of the following is correct regarding B-type natriuretic peptide (BNP)?
    BNP levels correlate with left ventricular pressure
    BNP is synthesized in the cardiac ventricles
    BNP levels correlate with the degree of dyspnea in patients with acute CHF
    BNP levels at time of discharge are predictive of the risk of subsequent hospitalization and death
    All of the above are correct

  5. The negative predictive value of BNP values under 80 pg/mL for the diagnosis of CHF is:
    20%
    70%
    89%
    98%

  6. Levels of BNP are elevated when heart failure is due to systolic dysfunction, but are normal in patients with heart failure with preserved systolic dysfunction.
    True
    False

  7. Which of the following hemodynamic parameters in patients with acute decompensated heart failure is most predictive of subsequent mortality?
    Cardiac index
    Systemic vascular resistance
    Pulmonary capillary wedge pressure
    Systemic blood pressure
    None of the above

  8. In the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) study, therapy with intravenous milrinone produced:
    No reduction in mean length of stay
    Increased risk of serious adverse events
    Trend for increased mortality
    All of the above

  9. An ideal agent for acute decompensated heart failure would have all but which of the following?
    Balanced arterial and venous vasodilation
    Rapid reduction in ventricular filling pressures
    Rapid relief of symptoms
    Direct intropic effect
    Promotion of naturiesis

  10. Nesiritide has all but which of the following hemodynamic effects in patients with acute decompensated heart failure?
    Reduction in right atrial pressure
    Reduction in pulmonary capillary wedge pressure
    Reduction in systemic vascular resistance
    Increase in heart rate

  11. In the Vasodilation in the Management of Acute Congestive Heart Failure (VMAC) study, what was the primary endpoint?
    Mean change in cardiac index at 48 hours baseline within 96 hours of contrast exposure
    Mean change in PCWP at 3 hours
    Adverse events at 24 hours
    More days out of the hospital in the 6 months after study entry


COURSE EVALUATION

Using a five-point scale (5 = strongly agree; 4 = agree; 3 = uncertain; 2 = disagree; 1 = strongly disagree), please answer the following evaluation questions.

1. The content seemed current: 5 4 3 2 1
2. The program content was relative to my practice: 5 4 3 2 1
3. Overall, the presentation provided a valuable learning experience: 5 4 3 2 1
4. My personal objectives in reading this presentation were fulfilled: 5 4 3 2 1
5. The presentation was a fair and balanced discussion
     and was not commercial in nature.		 5 4 3 2 1

The Institute for Medical Education designates this educational activity for a maximum of 1 hour in Category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

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