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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

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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

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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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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Heart Failure with Mid-range Ejection Fraction: Lessons from CHARM.

Lars H Lund1

  • 1Cardiology Unit, Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital Stockholm, Sweden.

Cardiac Failure Review
|September 13, 2018
PubMed
Summary
This summary is machine-generated.

Heart failure with mid-range ejection fraction (HFmrEF) is a new category. Candesartan treatment may improve outcomes for patients with HFmrEF, suggesting potential therapeutic benefits.

Keywords:
Heart failureangiotensin receptor blockercandesartanmid-range ejection fractionoutcomespreserved ejection fraction

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Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Trials

Background:

  • A new category of heart failure, HF with mid-range ejection fraction (HFmrEF; EF 40-49%), requires further characterization.
  • Existing research suggests standard therapies for HF with reduced ejection fraction (HFrEF; EF <40%) may benefit patients with higher ejection fractions (EF ≥40%).
  • The differential effects of HFrEF therapies on HFmrEF versus true HF with preserved ejection fraction (HFpEF) remain underexplored.

Purpose of the Study:

  • To investigate the efficacy of candesartan in patients diagnosed with HFmrEF.
  • To analyze data from randomized trials to understand treatment effects in this specific heart failure population.
  • To explore potential benefits of existing HFrEF therapies in the HFmrEF group.

Main Methods:

  • Analysis of pooled data from randomized trials within the CHARM program.
  • Focus on patient subgroups with ejection fraction between 40-49%.
  • Comparison of outcomes in HFmrEF patients treated with candesartan versus placebo or other interventions.

Main Results:

  • Data suggest that candesartan may lead to improved clinical outcomes in patients with HFmrEF.
  • The study provides initial evidence for the effectiveness of candesartan in this newly defined heart failure category.
  • Further analysis is needed to fully elucidate the benefits compared to HFpEF.

Conclusions:

  • Candesartan shows promise as a treatment option for heart failure with mid-range ejection fraction.
  • This study contributes to understanding therapeutic strategies for the HFmrEF population.
  • The findings warrant further investigation into targeted treatments for HFmrEF.