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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

1.0K
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...
1.0K
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

4.0K
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 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 Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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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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Related Experiment Video

Updated: Feb 14, 2026

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
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Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach

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Heart failure: a weak link in CHA2 DS2 -VASc.

Leif Friberg1,2, Lars H Lund3,4

  • 1Department of Clinical Sciences, Karolinska Institute, Stockholm, Sweden.

ESC Heart Failure
|February 16, 2018
PubMed
Summary

Heart failure is not an independent stroke risk factor in atrial fibrillation patients. The CHA2DS2-VASc score accurately predicts stroke risk without needing a separate heart failure assessment.

Keywords:
AnticoagulationAtrial fibrillationEpidemiologyHeart failureRegisterStroke

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Gene Transfer for Ischemic Heart Failure in a Preclinical Model
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Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Stroke risk in atrial fibrillation (AF) is assessed using the CHA2DS2-VASc score.
  • Heart failure (HF) is a component of this score, but its independent contribution to stroke risk is unclear.

Purpose of the Study:

  • To determine if heart failure is an independent risk factor for stroke in patients with atrial fibrillation.
  • To evaluate the impact of heart failure on stroke risk beyond other established CHA2DS2-VASc risk factors.

Main Methods:

  • A large cohort study of 300,839 patients with atrial fibrillation was conducted using the Swedish Patient Register (2005-2011).
  • Three different definitions of heart failure were applied to assess the robustness of findings.
  • Multivariable Cox regression analyses were used to assess associations between heart failure and stroke, adjusting for CHA2DS2-VASc risk factors.

Main Results:

  • Patients with heart failure were older and had a higher CHA2DS2-VASc score compared to those without.
  • The 1-year incidence of ischemic stroke was higher in patients with heart failure before adjustment.
  • After adjusting for CHA2DS2-VASc risk factors, the difference in stroke risk between patients with and without heart failure was eliminated (HR 1.01; 95% CI 0.96-1.05).
  • Adding heart failure to the CHA2DS2-VASc score did not improve its predictive ability for stroke.

Conclusions:

  • Clinical diagnosis of heart failure is not an independent predictor of stroke in atrial fibrillation patients.
  • These findings suggest that current anticoagulation management strategies based on the CHA2DS2-VASc score may not require modification for heart failure.
  • Re-evaluation of heart failure's role in stroke risk stratification for AF patients may be warranted.