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Related Concept Videos

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 Drugs: Diuretics01:22

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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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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

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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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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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Updated: Apr 27, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Association between renal function and cardiovascular structure and function in heart failure with preserved ejection

Mauro Gori1, Michele Senni2, Deepak K Gupta1

  • 1Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis St, Boston 02445, MA, USA.

European Heart Journal
|July 2, 2014
PubMed
Summary

Renal dysfunction is common in heart failure with preserved ejection fraction (HFpEF). It is linked to abnormal heart structure and function, with distinct impacts from reduced eGFR and albuminuria.

Keywords:
AlbuminuriaCardiovascular structure and functionChronic kidney diseaseGlomerular filtration rateHeart failure with preserved ejection fraction

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Area of Science:

  • Cardiology
  • Nephrology
  • Cardiorenal Medicine

Background:

  • Heart failure with preserved ejection fraction (HFpEF) frequently co-occurs with renal dysfunction.
  • Understanding the interplay between kidney function and cardiac structure/function in HFpEF is crucial for patient management.

Purpose of the Study:

  • To investigate the association between renal dysfunction and cardiovascular structure and function in patients with HFpEF.
  • To differentiate the effects of reduced estimated glomerular filtration rate (eGFR) and albuminuria on cardiac parameters in HFpEF.

Main Methods:

  • Analysis of 217 HFpEF participants from the PARAMOUNT study.
  • Echocardiography and kidney function assessments (eGFR, albuminuria) were performed.
  • Statistical evaluation of relationships between renal dysfunction markers and cardiac measures.

Main Results:

  • 62% of patients exhibited renal dysfunction (low eGFR and/or albuminuria).
  • Renal dysfunction correlated with abnormal left ventricular (LV) geometry, reduced midwall fractional shortening (MWFS), and elevated NT-proBNP.
  • Low eGFR was linked to abnormal LV geometry and MWFS, while albuminuria was associated with larger LV dimensions.

Conclusions:

  • Renal dysfunction is highly prevalent in HFpEF and associated with cardiac remodeling and systolic dysfunction.
  • Both reduced eGFR and albuminuria appear to play distinct roles in the cardiac manifestations of HFpEF.
  • These findings highlight the importance of assessing both eGFR and albuminuria in HFpEF patients.