Are hemodynamic goals viable in tailoring heart failure therapy? Hemodynamic goals are relevant.

The diversity of patient profiles and responses precludes a one-size-fits-all approach to heart failure. The randomized trials have provided us with some therapies that must be tried and others that can be tried. Offering significant although small benefits averaged over a population, these therapies are bolts of fabric stacked beside a tailor’s mannequin, the typical trial subject. The sequential patching of different medications in the order of their investigation, however, is not likely to yield the best regimen for any patient. There should be little disagreement on the principle of tailoring therapies for individuals, but what measurements should be taken?