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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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Cardiomyopathy V: Interprofessional Care01:29

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Heart Failure V: Medical Management01:30

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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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Mitral Stenosis IV: Nursing Management01:27

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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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Imbalances in Cardiac Output01:26

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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.
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Reply to Letter: "Bridging in Left Ventricular Assist Device Patients".

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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Pump Speed Optimization in Stable Patients with a Left Ventricular Assist Device.

Lotte E Couperus1, Victoria Delgado, Mand J H Khidir

  • 1From the *Department of Cardiology, LUMC, Leiden, The Netherlands; †Department of Cardiothoracic Surgery, LUMC, Leiden, The Netherlands; ‡Department of Medical Statistics and Bioinformatics, LUMC, Leiden, The Netherlands; and §Mathematical Institute, Leiden University, Leiden, The Netherlands.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 7, 2016
PubMed
Summary

Routine left ventricular assist device (LVAD) speed optimization improved right ventricular (RV) function in nearly half of stable destination therapy patients. This intervention enhanced RV function and reduced natriuretic peptide levels without RV dilation.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Left ventricular assist device (LVAD) performance and right ventricular (RV) function are critical for survival in destination therapy (DT) patients.
  • The impact of routine pump speed optimization on RV function in stable DT-LVAD recipients is not well understood.

Purpose of the Study:

  • To investigate the effects of routine LVAD speed optimization on RV function in stable DT-LVAD patients.
  • To determine the prevalence of patients who benefit from LVAD speed adjustments.

Main Methods:

  • A cohort of 17 hemodynamically stable DT-LVAD patients underwent a routine speed ramp test.
  • Echocardiography was used to assess RV function (fractional area change, peak systolic strain) at various LVAD speeds.
  • N-terminal pro-brain natriuretic peptide levels were measured at baseline and follow-up.

Main Results:

  • LVAD speed optimization was possible in 8 patients (47%).
  • Optimized patients showed significant improvements in RV fractional area change and RV longitudinal peak systolic strain at 3-month follow-up.
  • A decrease in N-terminal pro-brain natriuretic peptide levels was observed in patients with optimized LVAD speed, without RV dilation.

Conclusions:

  • Routine evaluation of LVAD speed is valuable for identifying patients who can benefit from optimization.
  • LVAD speed optimization can improve RV function and reduce cardiac strain markers in a significant portion of stable DT-LVAD patients.