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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 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 recovered ejection fraction.

Kazuaki Tanabe1, Takahiro Sakamoto2

  • 1Division of Cardiology, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, 693-8501, Japan. kaz@med.shimane-u.ac.jp.

Journal of Echocardiography
|September 16, 2018
PubMed
Summary

Heart failure patients who recover their left ventricular ejection fraction (LVEF) have unique characteristics and outcomes. Further research is needed to guide the management of these heart failure recovered (HFrecEF) patients.

Keywords:
EchocardiographyEjection fractionHeart failureLeft ventricle

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Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Medicine

Background:

  • Myocardial recovery and recovered left ventricular ejection fraction (HFrecEF) represent a distinct subgroup of heart failure (HF) patients.
  • These patients differ in etiology, comorbidities, treatment response, and outcomes compared to those with persistent reduced or preserved ejection fraction.
  • While improved LVEF correlates with better quality of life and reduced mortality/rehospitalization, HFrecEF patients still face higher mortality than the general population.

Purpose of the Study:

  • To review the specific characteristics, pathophysiology, and clinical implications of heart failure with recovered ejection fraction (HFrecEF).
  • To highlight the current lack of data guiding the management of HFrecEF patients.

Main Methods:

  • Literature review of studies focusing on myocardial recovery in heart failure.
  • Analysis of patient characteristics, etiological factors, and comorbidities in HFrecEF.
  • Examination of treatment responses and clinical outcomes in HFrecEF.

Main Results:

  • HFrecEF patients form a unique cohort with distinct clinical profiles.
  • Improved LVEF is associated with enhanced quality of life and decreased rehospitalization and mortality rates.
  • Despite improvements, HFrecEF patients exhibit higher morbidity and mortality compared to the general population.

Conclusions:

  • HFrecEF represents a significant clinical entity requiring further investigation.
  • Current management strategies for HFrecEF patients are not well-defined due to data limitations.
  • Understanding the specific pathophysiology and clinical trajectory of HFrecEF is crucial for optimizing patient care.