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To the Editor I read with interest Harinstein et al's review of clinical assessment in acute heart failure syndromes (AHFS).1 Initial assessment of AHFS included evaluation of important prognostic factors that influence treatment such as the presence of atrial fibrillation, acute pulmonary oedema and renal function. This is in accordance with the six-axis model described by Professor Gheorghiade. An important factor in the six-axis model, which has been neglected, is the role of blood pressure in the presentation and evaluation of AHFS. Blood pressure plays a critical role in the prognosis of acute heart failure and should be a central consideration …
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