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Related Concept Videos

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 III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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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...
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Hazard Rate01:11

Hazard Rate

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The hazard rate, also known as the hazard function or failure rate, is a statistical measure used to describe the instantaneous rate at which an event occurs, given that the event has not yet happened. From a probabilistic perspective, it represents the likelihood that a subject will experience the event in a very small time interval, conditional on surviving up to the beginning of that interval. In terms of frequency, the hazard rate can be viewed as the ratio of the number of events to the...
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Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

579
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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Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

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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,...
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Related Experiment Video

Updated: Mar 27, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Temporal Changes in Postdischarge Mortality Risk After Hospitalization for Heart Failure (from the EVEREST Trial).

Thomas D Cook1, Stephen J Greene2, Andreas P Kalogeropoulos3

  • 1Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin.

The American Journal of Cardiology
|January 9, 2016
PubMed
Summary

The risk of death for patients hospitalized for heart failure (HHF) is primarily determined by individual risk profiles, not temporal changes post-discharge. Long-term interventions for high-risk patients are crucial for reducing mortality.

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Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Observational studies show highest mortality risk for heart failure patients immediately after hospital discharge.
  • It remains unclear if this reflects declining individual risk or shifts in population case-mix.
  • Understanding post-discharge mortality trajectories is vital for effective heart failure management.

Purpose of the Study:

  • To estimate temporal changes in post-discharge all-cause mortality risk in patients hospitalized for heart failure (HHF).
  • To differentiate between individual patient risk decline and population case-mix changes influencing mortality.
  • To inform strategies for reducing all-cause mortality in heart failure patients.

Main Methods:

  • Utilized survival rate and longitudinal models on data from 3,993 HHF patients discharged alive from the EVEREST trial.
  • Analyzed postdischarge all-cause mortality risk over a median follow-up of 9.9 months.
  • Employed serial risk reassessment using a longitudinal model based on follow-up visit data.

Main Results:

  • The overall predicted mortality rate decreased initially post-discharge but increased steadily thereafter.
  • Individual patient risk variation was significantly larger than temporal variations within risk strata.
  • Predicted mortality risk rose in the 90 days preceding readmission, then followed a similar postdischarge trajectory.

Conclusions:

  • An individual patient's risk profile, not temporal changes relative to hospitalization, is the main determinant of mortality.
  • Transiently elevated individual patient risk exists in the 90 days before and after discharge.
  • Long-term interventions based on serial risk assessments are recommended for high-mortality risk heart failure patients.