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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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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

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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 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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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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Right Atrial Phasic Function in Heart Failure With Preserved and Reduced Ejection Fraction.

Snigdha Jain1, Daniel Kuriakose2, Ilaina Edelstein2

  • 1Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.

JACC. Cardiovascular Imaging
|October 22, 2018
PubMed
Summary

Right atrial (RA) function, specifically its reservoir and conduit roles, independently predicts all-cause mortality in patients with and without heart failure (HF). Impaired RA phasic function is a significant prognostic indicator.

Keywords:
feature trackinglongitudinal strainmagnetic resonance imagingright atrium

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Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Prognostics

Background:

  • Left atrial dysfunction is recognized in heart failure (HF), but right atrial (RA) dysfunction patterns and prognostic value remain unclear.
  • Cardiac magnetic resonance (CMR) imaging offers detailed visualization of the RA, enabling characterization of its function.

Purpose of the Study:

  • To characterize right atrial (RA) phasic function using CMR in patients with and without heart failure (HF).
  • To assess the prognostic implications of RA dysfunction on all-cause mortality.

Main Methods:

  • Prospective study of 608 adults (407 without HF, 105 with HFrEF, 96 with HFpEF).
  • RA phasic function assessed via CMR volume measurements and feature-tracking for longitudinal strain.
  • All-cause death ascertained over a median follow-up of 38.9 months; Cox regression used for analysis.

Main Results:

  • RA phasic function was more impaired in HFrEF than HFpEF.
  • Adjusted analyses revealed RA reservoir strain, RA expansion index, RA conduit strain, and RA conduit strain rate independently predicted all-cause mortality.
  • RA booster pump function and RA volume index did not independently predict mortality.

Conclusions:

  • Phasic right atrial (RA) function is a significant predictor of all-cause mortality in individuals with and without heart failure (HF).
  • RA conduit and reservoir functions are identified as independent predictors of mortality, highlighting their prognostic importance.