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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

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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

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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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Heart Failure With Preserved Ejection Fraction In Perspective.

Marc A Pfeffer1, Amil M Shah1, Barry A Borlaug2

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Heart failure with preserved ejection fraction (HFpEF) affects many patients and carries significant risks. Further research into HFpEF, including specific patient subgroups, is crucial for improving treatment outcomes.

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clinical trials, phase IIIepidemiologyheart failureheart failure, diastolic

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Area of Science:

  • Cardiology
  • Heart Failure Research

Background:

  • Heart failure (HF) affects approximately half of patients with symptoms but normal or near-normal left ventricular ejection fraction (LVEF).
  • Patients with HF and preserved ejection fraction (HFpEF) face heightened risks for major adverse cardiovascular events, similar to those with reduced ejection fraction.
  • The prevalence and clinical significance of HFpEF have gained recognition over the last two decades, driving extensive research and clinical trials.

Purpose of the Study:

  • To review the historical development, epidemiology, and pathophysiology of HFpEF.
  • To discuss current and planned therapeutic strategies for HFpEF.
  • To highlight the need for advanced patient phenotyping and genotyping to improve trial outcomes.

Main Methods:

  • Literature review of historical developments in HFpEF.
  • Analysis of epidemiological data and pathophysiological mechanisms.
  • Overview of ongoing and planned clinical outcome trials.

Main Results:

  • HFpEF represents a substantial and often underestimated component of the heart failure syndrome.
  • Adverse event risks in HFpEF are significant across the spectrum of ejection fraction.
  • Clinical investigation and outcome trials for HFpEF have intensified.

Conclusions:

  • Understanding HFpEF requires a comprehensive approach, including its history, mechanisms, and treatment landscape.
  • Future therapeutic advancements depend on precise patient stratification through phenotyping and genotyping.
  • Targeted therapies hold promise for improving outcomes in diverse HFpEF subpopulations.