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Related Concept Videos

Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

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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.
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Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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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...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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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...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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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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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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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...
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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
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[Heart failure with preserved left ventricular ejection fraction].

Micha T Maeder1, Hans Rickli

  • 1Fachbereich Kardiologie, Kantonsspital St. Gallen.

Praxis
|October 17, 2013
PubMed
Summary
This summary is machine-generated.

Heart failure with preserved ejection fraction (HFpEF) is common in older adults and involves diastolic dysfunction. Current treatments do not improve survival, but research is ongoing.

Keywords:
AuswurffraktionHerzinsuffizienzdiastolicdiastolischdysfonction diastoliqueejection fractionerhaltenfonction systolique préservéefraction d'éjectionheart failureinsuffisance cardiaquenormalpreserved

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Area of Science:

  • Cardiology
  • Geriatrics
  • Internal Medicine

Background:

  • Heart failure with preserved left ventricular ejection fraction (HFpEF) is a prevalent condition, particularly in the elderly.
  • It is often associated with advanced hypertensive heart disease and characterized by diastolic dysfunction.
  • Patients experience dyspnoea and fatigue due to impaired left ventricular filling and increased filling pressures.

Purpose of the Study:

  • To outline the diagnostic criteria for HFpEF.
  • To highlight the challenges in managing HFpEF compared to heart failure with reduced ejection fraction.
  • To underscore the need for effective treatments and ongoing research.

Main Methods:

  • Diagnosis involves excluding non-cardiac and other cardiac causes of dyspnoea.
  • Key findings include a non-dilated left ventricle with preserved ejection fraction (>50%) and significant diastolic impairment.
  • Assessment tools include invasive hemodynamics, echocardiography, and natriuretic peptides.

Main Results:

  • HFpEF is characterized by concentric remodeling, normal LVEF, reduced longitudinal shortening, and diastolic dysfunction.
  • Impaired diastolic filling leads to increased filling pressures and limits stroke volume increase during exercise.
  • No established treatments currently prolong survival or reduce hospitalizations for HFpEF.

Conclusions:

  • HFpEF diagnosis requires careful exclusion of other conditions and confirmation of diastolic impairment.
  • Effective therapeutic strategies for HFpEF are lacking, unlike for heart failure with reduced ejection fraction.
  • Intensive research is underway, with clinical trial results anticipated in the coming years.