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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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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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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 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 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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Updated: Feb 22, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Skeletal muscle alterations in HFrEF vs. HFpEF.

Volker Adams1, Axel Linke2, Ephraim Winzer2

  • 1Clinic of Cardiology, Heart Center Leipzig, Strümpellstrasse 39, 04289, Leipzig, Germany. adav@medizin.uni-leipzig.de.

Current Heart Failure Reports
|September 24, 2017
PubMed
Summary

Skeletal muscle alterations contribute to exercise intolerance in heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF). More research is needed, especially for HFpEF, to understand these changes.

Keywords:
Heart failureHeart failure with preserved ejection fractionHeart failure with reduced ejection fractionSkeletal muscle

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Area of Science:

  • Cardiology
  • Exercise Physiology
  • Skeletal Muscle Biology

Background:

  • Heart failure patients, regardless of ejection fraction, experience significant exercise intolerance and fatigue.
  • Skeletal muscle dysfunction is a recognized contributor to these symptoms in heart failure.

Purpose of the Study:

  • To provide a contemporary summary of skeletal muscle alterations in heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
  • To identify future research directions for improving the understanding of skeletal muscle changes in heart failure.

Main Methods:

  • This review synthesizes current knowledge on skeletal muscle alterations in HFrEF and HFpEF.
  • It examines changes in fiber type, capillarization, atrophy, and mitochondrial function.

Main Results:

  • Skeletal muscle alterations are well-documented in HFrEF for over two decades and increasingly recognized in HFpEF.
  • Observed changes include shifts in fiber type, reduced capillarization, muscle atrophy, and altered mitochondrial energy supply.
  • Molecular alterations are generally more pronounced in HFrEF compared to HFpEF.

Conclusions:

  • Skeletal muscle molecular alterations likely contribute to exercise intolerance in both HFrEF and HFpEF.
  • Current understanding of skeletal muscle changes in HFpEF remains limited, necessitating further investigation in this patient group.