Heart failure research paradigms using bedside observation on endothelialmuscle common denominators to highlight important translational questions

Background & aim : Congestive heart failure (CHF) imposes a relevant burden on healthcare systems, as it is associated with high morbidity and mortality rates and considerable costs. Within the last three to four decades, there have been revolutionary advancements, particularly in the pharmaceutical industry. In addition, health services research at the population level has also delivered. A third avenue for advancing the clinical management of CHF is to explore established therapies with a new approach. In this perspective, we explore these established concepts and provide impetus for using bedside observations to find improvements in CHF outcomes. Conclusion: There are potentially new concepts that can be brought to established solutions for CHF. Encouraging observations when delivering established guideline-directed medical therapies are issues that the evidence-based medicine community should factor alongside novel discoveries to improve CHF prognosis. An emphasis on innovating on the known can be considered as an important paradigm for discovery. Relevance for patients : Patients with CHF receiving current available treatments have improved outcomes; however those not improving could be considered under evolving research paradigms.