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Related Concept Videos

Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure IV: Classification and Diagnostic Evaluation01:30

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...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Heart Failure II: Pathophysiology01:29

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 I: Introduction01:27

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...

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Related Experiment Video

Updated: Jun 6, 2026

Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix
09:11

Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix

Published on: September 22, 2014

The Heart Failure Revascularisation Trial (HEART).

John G F Cleland1, Melanie Calvert, Nick Freemantle

  • 1Department of Cardiology, Castle Hill Hospital, University of Hull, Kingston upon Hull HU16 5JQ, UK.

European Journal of Heart Failure
|December 16, 2010
PubMed
Summary

Conservative management may be as effective as revascularization for heart failure patients with viable myocardium. This underpowered study suggests further trials are needed to confirm findings for coronary artery disease treatment.

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Published on: April 17, 2021

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Revascularization is often recommended for heart failure patients with coronary artery disease and viable myocardium.
  • The optimal management strategy for these patients remains a subject of ongoing research.

Purpose of the Study:

  • To compare the effectiveness of conservative management versus revascularization in patients with heart failure, coronary artery disease, and significant myocardial viability.

Main Methods:

  • A randomized trial was designed to enroll 800 patients, but only 138 were recruited due to funding withdrawal and the availability of larger concurrent trials.
  • Patients with left ventricular ejection fraction < 35% and viable myocardium were assigned to either conservative management or an invasive strategy with intent for revascularization.
  • Exclusions included patients needing revascularization for angina or those too frail for surgery.

Main Results:

  • After a median follow-up of 59 months, 51 deaths occurred (37% overall).
  • Mortality rates were similar between the conservative (37%) and invasive (38%) groups.
  • Among those undergoing revascularization, the mortality rate was 29%.

Conclusions:

  • Conservative management may not be inferior to revascularization in selected heart failure patients.
  • The study was significantly underpowered, limiting definitive conclusions.
  • Larger clinical trials are necessary to definitively address the role of revascularization in this patient population.