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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 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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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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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...
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Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

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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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Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
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Right ventricular function in heart failure with preserved ejection fraction: a community-based study.

Selma F Mohammed1, Imad Hussain2, Omar F AbouEzzeddine

  • 1From the Division of Cardiovascular Diseases (S.F.M., I.H., O.F.A.E., H.T., S.H.K., V.L.R., M.M.R.), Mayo Graduate School (S.F.M.), and Department of Health Sciences Research (V.L.R.), Mayo Clinic, Rochester, MN; and Division of Cardiovascular Medicine, Temple University, Philadelphia, PA (P.F.). mohammed.selma@mayo.edu.

Circulation
|November 14, 2014
PubMed
Summary

Right ventricular systolic dysfunction (RVD) is common in heart failure with preserved ejection fraction (HFpEF) patients and predicts worse outcomes, including higher mortality and hospitalization rates. This finding highlights the clinical significance of RVD in HFpEF management.

Keywords:
diastoleheart failurehypertension, pulmonaryventricular dysfunction, right

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

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Right ventricular systolic dysfunction (RVD) prevalence and significance in heart failure with preserved ejection fraction (HFpEF) remain unclear.
  • HFpEF affects a significant patient population, necessitating a better understanding of contributing factors and prognostic indicators.

Purpose of the Study:

  • To characterize the prevalence and clinical significance of RVD in a community-based HFpEF cohort.
  • To determine the association of RVD with clinical characteristics, echocardiographic findings, and patient outcomes.

Main Methods:

  • Prospective identification of 562 HFpEF patients meeting Framingham criteria (ejection fraction ≥50%).
  • Echocardiography at diagnosis and follow-up to assess RV function using tricuspid annular plane systolic excursion and semiquantitative 2D assessment.
  • Analysis of cause-specific mortality and HF hospitalization rates, adjusted for relevant covariates.

Main Results:

  • RVD was identified in a substantial proportion of HFpEF patients, often associated with atrial fibrillation, pacemakers, and diuretic use.
  • Patients with RVD exhibited lower left ventricular ejection fraction, worse diastolic dysfunction, lower blood pressure, higher pulmonary artery systolic pressure, and more severe RV enlargement and tricuspid regurgitation.
  • RVD independently predicted higher all-cause and cardiovascular mortality, as well as increased rates of HF hospitalization, regardless of definition used (semiquantitative or tricuspid annular plane systolic excursion).

Conclusions:

  • Right ventricular systolic dysfunction is a frequent finding in community-based HFpEF patients.
  • RVD is linked to more advanced HF characteristics and portends a poorer prognosis.
  • Assessment of RV function is crucial for risk stratification and management of HFpEF.