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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

929
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

971
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

319
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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[Heart Failure in Patients With Preserved Ejection Fraction - Pumping Heart Failure?]

A A Sokolov1, G I Martsinkevich1

  • 1Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences.

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|October 27, 2018
PubMed
Summary

Chronic heart failure (CHF) involves organ hypoperfusion due to circulatory inadequacy. Focusing on diastolic heart failure, researchers found reduced cardiac output (CO) is key, suggesting metabolic balance is crucial for treatment.

Keywords:
heart failureheart failure with preserved ejection fraction

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Physiology

Background:

  • Chronic heart failure (CHF) is a clinical syndrome characterized by organ and system hypoperfusion.
  • This hypoperfusion results from various causes of circulatory pumping inadequacy.
  • Diastolic heart failure, a specific form of CHF, warrants particular attention due to its complex etiology.

Purpose of the Study:

  • To analyze literature data on chronic heart failure, with a focus on diastolic heart failure.
  • To highlight indexed cardiac output (CO) as a more integrated characteristic of CHF than ejection fraction.
  • To explore therapeutic strategies for diastolic heart failure, particularly those addressing metabolic imbalances.

Main Methods:

  • Literature review and analysis of existing data on chronic heart failure.
  • Examination of etiological factors contributing to diastolic heart failure.
  • Evaluation of the role of cardiac output and ejection fraction in assessing CHF severity.

Main Results:

  • Reduced cardiac output (CO) is a universal finding in heart failure, regardless of origin, leading to diminished tissue oxygen and substrate supply.
  • The distinction between systolic and diastolic CHF is considered a conventional concept, with CO being a more integrated measure.
  • The diverse causes of heart failure with preserved ejection fraction complicate hemodynamic management with standard drug regimens.

Conclusions:

  • Normalization of the balance between oxygen/substrate delivery and tissue metabolic demand may be a pivotal therapeutic strategy for diastolic heart failure.
  • Indexed cardiac output (CO) serves as a more comprehensive quantitative marker for CHF than ejection fraction.
  • Addressing the underlying metabolic demands is essential for effective treatment of various forms of diastolic heart failure.