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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

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 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 8, 2026

A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
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Coronary Microcirculation in Heart Failure with Preserved Systolic Function.

Zorana Vasiljevic1, Gordana Krljanac1,2, Marija Zdravkovic1,3

  • 1University of Belgrade, Faculty of Medicine, Belgrade, Serbia.

Current Pharmaceutical Design
|July 12, 2018
PubMed
Summary

Heart Failure with Preserved Ejection Fraction (HFpEF) involves coronary microcirculation issues. Diagnostic tools like echocardiography and CMR imaging are key, but understanding and treating HFpEF remains challenging.

Keywords:
Cardiac magnetic resonanceCoronary flow reserveCoronary microvascular dysfunctionDiastolic dysfunctionHeart failure with preserved ejection fractionTroponin level.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart Failure with Preserved Ejection Fraction (HFpEF) is characterized by preserved left ventricular ejection fraction (LVEF) alongside heart failure symptoms.
  • HFpEF shares similar mortality and hospital readmission rates with Heart Failure with Reduced Ejection Fraction (HFrEF).
  • Coronary microvascular ischemia, cardiomyocyte injury, and stiffness are implicated in HFpEF pathophysiology.

Purpose of the Study:

  • To analyze the relationship between HFpEF and coronary microcirculation based on existing studies.

Main Methods:

  • Review of previous studies examining HFpEF and coronary microcirculation.
  • Evaluation of diagnostic markers including transthoracic echocardiography (TTE), coronary flow reserve (CFR), fractional flow reserve (FFR), and quantitative myocardial contrast echocardiography (MCE).
  • Consideration of cardiac magnetic resonance (CMR) imaging as a diagnostic gold standard.

Main Results:

  • TTE parameters, CFR, FFR, and MCE show potential as diagnostic markers for coronary microcirculation in HFpEF.
  • Cardiac magnetic resonance (CMR) imaging is identified as the gold standard for HFpEF diagnosis.
  • Coronary microvascular dysfunction, particularly in women without obstructive coronary artery disease, is poorly understood. Troponin levels may aid in risk stratification.

Conclusions:

  • Pathophysiological mechanisms of HFpEF, especially coronary microvascular dysfunction, require further elucidation.
  • Precise clinical assessments and diagnostic methods for coronary microvascular and diastolic dysfunction in HFpEF are lacking.
  • There is currently no well-established treatment for HFpEF.