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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

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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

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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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Diagnosing heart failure in centenarians.

Signe Høi Rasmussen1,2, Karen Andersen-Ranberg1,2, Jordi Sanchez Dahl3

  • 1Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark.

Journal of Geriatric Cardiology : JGC
|February 26, 2019
PubMed
Summary
This summary is machine-generated.

Heart failure is common in centenarians, with over half showing left ventricular dysfunction, often without symptoms. Brain Natriuretic Peptide (BNP) may not be a reliable heart failure biomarker in this exceptional age group.

Keywords:
Brain Natriuretic PeptideCentenarianHeart failureIn-home echocardiographyLeft ventricular dysfunction

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Area of Science:

  • Gerontology
  • Cardiology
  • Epidemiology

Background:

  • Increasing life expectancy leads to a higher prevalence of heart failure (HF).
  • Limited data exists on cardiac structure and function in the very old population.
  • Understanding HF in centenarians is crucial for public health and economic planning.

Purpose of the Study:

  • To investigate cardiac structure and function in a population-based sample of centenarians.
  • To assess the prevalence of left ventricular (LV) dysfunction and heart failure symptoms in this cohort.
  • To evaluate the utility of Brain Natriuretic Peptide (BNP) as a biomarker for HF in centenarians.

Main Methods:

  • A population-based study of individuals turning 100 years old in western Denmark.
  • In-home interviews and echocardiography were offered to consenting participants.
  • Plasma BNP levels were measured and correlated with cardiac function and symptoms.

Main Results:

  • Left ventricular (LV) dysfunction was found in 54% of participants, with most being asymptomatic.
  • Pulmonary hypertension was present in 42% of participants, independent of LV function.
  • The correlation between elevated BNP levels and LV dysfunction, typically seen in younger populations, was not confirmed.

Conclusions:

  • More than half of centenarians exhibit LV dysfunction, often without typical heart failure symptoms.
  • Current diagnostic criteria for HF may be less applicable to centenarians due to symptom validity and biomarker limitations.
  • BNP appears to lose its diagnostic value for ruling out heart failure in the centenarian population.