Hypothesis-driven research has dominated biomedical science for at least the past century. There are many papers and grant applications that will have been rejected because they are not hypothesis-driven. For example, Haufe reports that the NIH guidelines for RO1 grants states that “A strong grant application is driven by a strong, solid hypothesis with clear research objectives”.

Bromodomain-containing protein 4 (BRD4) is a member of the mammalian bromo- and extra-terminal domain (BET) protein family, which also comprises BRD2, BRD3, and testis-specific BRDt.

Diastolic heart failure (DHF) is also be regarded as heart failure with preserved ejection fraction (HFpEF), is estimated to occur in 40 to 50% of patients with HF. More than 70% of HF patients over the age of 65 had HFpEF, and the incidence and prevalence of HFpEF has been increased by 10% every 10 years in comparison to HF with reduced ejection fraction (HFrEF), and this gap is expected to widen in the coming years.

Heart failure affects 1-2% of the adult population in developed countries and the lifetime risk of a heart failure diagnosis is 20%. Patients with heart failure have markedly reduced life expectancy, physical capacity and quality of life. One-year all-cause mortality rates for heart failure patients range between 7 and 17% and the yearly hospitalization rate can be as high as 44%.

Secondary prevention of cardiovascular disease such as heart failure includes regular physical activity with endurance and strength training, which is used for this purpose with high prevalence. Early rehabilitation should begin in hospital (phase I), be continued in a rehabilitation clinic or as an outpatient close to home (phase II), and then (phase III) preferably in outpatient heart groups (AHG).