RESUMO
ChatGPT (Generative Pre-trained Transformer) is a large-scale language processing model, with possibilities for professional patient support in a patient-friendly way. The aim of the study was to examine the accuracy and reproducibility of ChatGPT in answering questions about knowledge and management of heart failure (HF). First, we recorded 47 most frequently asked questions by patients about HF. The answers of ChatGPT to these questions were independently assessed by two researchers. ChatGPT was able to render the definition of the disease in a very simple and explanatory way. It listed a number of the most important causes of HF and the most important risk factors for its occurrence. It provided correct answers about the most important diagnostic tests and why they are recommended. In addition, it answered health and dietary questions, such as the daily fluid and the alcohol intake. ChatGPT listed the most important classes of drugs in HF and their mechanism of action. It also answered with arguments to questions about patient's sex life, whether they could work, drive, or travel by plane. The performance of ChatGPT was described as very good as it was able to adequately answer all questions posed to it.
RESUMO
Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life. However, the instructions for the prescriptive or recommended exercise in hypertensive patients and, more specifically, in those with HFpEF are not well defined. Moreover, the evidence is based on observational or small randomized studies, while well-designed clinical trials are lacking. Despite the proven benefit and the guidelines' recommendations, exercise programs and cardiac rehabilitation in patients with hypertensive heart disease and HFpEF are grossly underutilized. This position statement provides a general framework for exercise and exercise-based rehabilitation in patients with hypertension and HFpEF, guides clinicians' rehabilitation strategies, and facilitates clinical practice. It has been endorsed by the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology and is focused on the Health Care System in Greece.
Assuntos
Reabilitação Cardíaca , Cardiologia , Insuficiência Cardíaca , Hipertensão , Humanos , Qualidade de Vida , Volume Sistólico , Hipertensão/complicações , Hipertensão/epidemiologia , Exercício FísicoRESUMO
Despite significant advancements in medical therapy, heart failure with reduced ejection fraction (HFrEF) continues to be a significant cause of death and disability. Reversible ischaemic left ventricular dysfunction due to viable myocardium is one such contributing factor. In these cases, coronary revascularization has shown promise in improving left ventricular function and prognosis. For patients with HFrEF and wide QRS, cardiac resynchronization therapy (CRT) is an effective option to address electromechanical dyssynchrony. However, approximately 30% of patients do not respond positively to CRT, highlighting the need to refine candidate selection for this treatment. In some patients with reduced HFrEF, there is a condition known as classical low-flow, low-gradient aortic stenosis (AS) that may be observed. This condition is characterized by a low transaortic flow, which leads to reductions in both the transaortic mean gradient and aortic valve area. Decision-making regarding revascularization, CRT, and pharmacological treatment play a crucial role in managing HFrEF. Cardiac imaging can be valuable in guiding decision-making processes and assessing the prognosis of patients with HFrEF. Among the imaging modalities, dobutamine stress echocardiography has come a long way in establishing itself as a feasible, safe, effective, relatively cheap non-invasive technique. The aim of this review is to explore the current literature on the utility of low-dose stress echocardiography in diagnosing and prognosticating patients with HFrEF.
