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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

332
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

963
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

308
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 mortality compared between elderly and non-elderly Thai patients.

Rungroj Krittayaphong1, Khemajira Karaketklang2, Ahthit Yindeengam1

  • 1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Journal of Geriatric Cardiology : JGC
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PubMed
Summary

Elderly Thai patients hospitalized for heart failure face significantly higher mortality rates. This highlights a critical need for improved care and follow-up strategies for this vulnerable population.

Keywords:
Heart failureMortalityOutcomesThai populationThe elderly

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Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Heart failure is a major cause of hospitalization and mortality globally.
  • The impact of age on heart failure outcomes, particularly in diverse populations, requires further investigation.

Purpose of the Study:

  • To compare heart failure mortality rates between elderly and non-elderly patients in Thailand.
  • To identify risk factors associated with mortality in Thai heart failure patients.

Main Methods:

  • A retrospective study analyzed 201,709 heart failure admissions from 2008-2012 across three major Thai reimbursement systems.
  • Patients were categorized as elderly (>65 years) or non-elderly (≤65 years).
  • Mortality rates, survival analyses, and associated factors (demographics, comorbidities) were compared between groups.

Main Results:

  • The overall mortality rate post-heart failure hospitalization was 50.8%.
  • Elderly patients exhibited significantly higher all-cause mortality (adjusted OR 1.47), cardiovascular death (adjusted OR 1.25), and non-cardiovascular death (adjusted OR 1.72) compared to non-elderly patients.
  • Elderly status was identified as the second strongest predictor of mortality after heart failure hospitalization, following chronic kidney disease.

Conclusions:

  • Heart failure hospitalization carries a substantial mortality risk in Thailand, exceeding 50%.
  • Advanced age is an independent predictor of mortality following heart failure hospitalization.
  • There is an urgent need to enhance the quality of care and follow-up for elderly Thai heart failure patients.