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Heart Failure I: Introduction

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...

Pathophysiology of Heart Failure

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

Heart Failure III: Clinical Manifestations

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...

Imbalances in Cardiac Output

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...

Heart Failure II: Pathophysiology

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...

Heart Failure IV: Classification and Diagnostic Evaluation

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...

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Updated: Jun 23, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

Heart failure.

Robert Samuel McKelvie¹

¹McMaster University, Hamilton, ON, Canada.

BMJ Clinical Evidence

|May 21, 2009

Summary

This systematic review evaluates various heart failure treatments, including drugs, non-drug therapies, and invasive procedures. It provides evidence on the effectiveness and safety of interventions for improving patient outcomes and reducing mortality.

Area of Science:

Cardiology
Clinical Medicine
Evidence-Based Practice

Background:

Heart failure affects 3-4% of adults over 65, often stemming from coronary artery disease or hypertension.
It leads to breathlessness, reduced exercise tolerance, fluid retention, and elevated mortality rates.
Systolic heart failure carries a 5-year mortality of 25-75%, with ventricular arrhythmia a common cause of sudden death.

Purpose of the Study:

To systematically review the effects of drug, non-drug, and invasive treatments for heart failure.
To assess the impact of angiotensin-converting enzyme inhibitors in high-risk individuals.
To evaluate treatments specifically for diastolic heart failure.

Main Methods:

Conducted a systematic literature review up to January 2007.

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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

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Last Updated: Jun 23, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Searched major databases including Medline, Embase, and The Cochrane Library.

Included harms alerts from regulatory agencies like the FDA and MHRA.

Main Results:

Identified 72 systematic reviews, RCTs, and observational studies meeting inclusion criteria.
Performed a GRADE evaluation to assess the quality of evidence for various interventions.
Synthesized information on the effectiveness and safety of numerous treatments.

Conclusions:

The review details the effectiveness and safety of interventions such as ACE inhibitors, ARBs, beta-blockers, and cardiac resynchronisation therapy.
It also covers anticoagulation, antiplatelet agents, implantable cardiac defibrillators, and multidisciplinary interventions.
Information on specific drugs like amiodarone, digoxin, and spironolactone is presented, alongside non-drug options like exercise.