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Heart Rate Effects Change in Pulse at Week 48 (LS Mean, 95% CI) (Data from Supplementary Appendix, Table S12) Placebo: +0.4 bpm (1.5 to +2.3) Retatrutide 1 mg: +1.7 bpm (0.7 to +4.0) 4 mg (ID 2 mg): +3.0 bpm (+1.1 to +4.9) 4 mg (ID 4 mg): +3.2 bpm (+0.8 to +5.6) 8 mg (ID 2 mg): +4.3 bpm (+1.5 to +7.1) 8 mg (ID 4 mg): +5.2 bpm (+2.2 to +8.1) 12 mg (ID 2 mg): +6.0 bpm (+3.7 to +8.3) Interpretation Retatrutide induces a clear, dose-dependent increase in heart rate

Doppler-guided hemorrhoidal artery ligation Doppler-guided hemorrhoidal artery ligation involves using a Doppler probe to find and ligate individual hemorrhoidal arteries