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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Heart Failure II: Pathophysiology01:29

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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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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Mitral Regurgitation I: Introduction01:20

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Left ventricular dysfunction in COPD without pulmonary hypertension.

Janne M Hilde1,2, Jonny Hisdal1,3, Ingunn Skjørten2,4

  • 1Department of Cardiology, Oslo University Hospital-Aker, Oslo, Norway.

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|July 17, 2020
PubMed
Summary
This summary is machine-generated.

Subclinical left ventricular (LV) systolic dysfunction is common in chronic obstructive pulmonary disease (COPD) patients, even without pulmonary hypertension. Diastolic dysfunction was not evident using standard echocardiographic measures.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Echocardiography

Background:

  • Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular complications.
  • Left ventricular (LV) function in stable COPD patients requires further investigation, especially in the absence of overt cardiac disease.

Purpose of the Study:

  • To evaluate the prevalence of left ventricular (LV) systolic and diastolic dysfunction in stable COPD patients.
  • To assess LV function in relation to pulmonary artery pressure in COPD.

Main Methods:

  • 100 COPD patients (GOLD II-IV) and 34 controls underwent echocardiography.
  • LV myocardial performance index (MPI) and strain assessed systolic function.
  • Diastolic function evaluated using E/A ratio, E´, E/E´, isovolumic relaxation time, and left atrium volume.

Main Results:

  • Abnormal LV MPI (≥0.51) found in 64.9% and LV strain (≤-15.8%) in 62.2% of COPD-non-PH patients.
  • Abnormal LV MPI and strain were also observed in patients with mean pulmonary artery pressure (mPAP) <20 mmHg.
  • Standard diastolic echo indices did not significantly differ between COPD-non-PH patients and controls.

Conclusions:

  • Subclinical LV systolic dysfunction is frequent in COPD patients, irrespective of pulmonary artery pressure.
  • Conventional echocardiographic indices showed minimal evidence of LV diastolic dysfunction in this COPD cohort.