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This meta-analysis concluded that there was insufficient evidence to recommend the routine use of inhaled steroids in adults with stable state BE but considered that a therapeutic trial might be justified in patients with difficult to control symptoms

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Additionally, the pathophysiological mechanisms contributing to HF may be complex, not solely attributed to left ventricular systolic dysfunction and volume overload but also potentially linked to right ventricular impairment or HF with preserved ejection fraction (HFpEF) (Ngele and Flammer, 2022)

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