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Related Concept Videos

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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Pathophysiology of Heart Failure01:17

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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 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 Drugs: Inhibitors of Renin-Angiotensin System01:26

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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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Mitral Regurgitation I: Introduction01:20

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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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Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
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Retinal microvascular dysfunction in heart failure.

Matthias P Nägele1, Jens Barthelmes1, Valeria Ludovici1,2

  • 1Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

European Heart Journal
|October 26, 2017
PubMed
Summary
This summary is machine-generated.

Retinal microvascular dysfunction, identified via retinal vessel analysis (RVA), is significantly present in chronic heart failure (CHF) patients. This non-invasive RVA method can monitor heart failure-related microvascular changes.

Keywords:
Endothelial dysfunctionHeart failureMicrocirculationRetinal vessel analysis

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Area of Science:

  • Ophthalmology
  • Cardiology
  • Vascular Biology

Background:

  • Chronic heart failure (CHF) is associated with systemic microvascular dysfunction.
  • Retinal vessel analysis (RVA) offers a non-invasive method to assess ocular microcirculation.
  • Understanding retinal microvascular changes in CHF can provide insights into disease pathophysiology.

Purpose of the Study:

  • To evaluate retinal microvascular function in patients with CHF.
  • To compare retinal microvascular dysfunction in CHF patients against those with cardiovascular risk factors (CVRF) and healthy controls (HC).
  • To explore the relationship between retinal microvascular changes and established measures of vascular function.

Main Methods:

  • Prospective, observational study including 74 CHF patients, 74 CVRF patients, and 74 HC.
  • Primary endpoint: flicker-induced dilatation of retinal arterioles (FIDart).
  • Secondary endpoints included flicker-induced venular dilatation (FIDven), arteriovenous ratio, and flow-mediated dilatation.

Main Results:

  • Significantly reduced FIDart in CHF patients compared to CVRF and HC (P < 0.001).
  • Impaired FIDven was observed in CHF patients and associated with pulmonary artery pressure and left atrial volume.
  • No significant differences in arteriovenous ratio or flow-mediated dilatation were found between groups.

Conclusions:

  • Retinal microvascular dilatation is impaired in patients with CHF.
  • RVA is a promising non-invasive tool for monitoring microvascular abnormalities in heart failure.
  • Standardized RVA can facilitate easy and radiation-free assessment of microvascular health in CHF.