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Related Concept Videos

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 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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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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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.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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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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Related Experiment Video

Updated: Oct 20, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Untangling the pathophysiologic link between coronary microvascular dysfunction and heart failure with preserved

Aish Sinha1, Haseeb Rahman1, Andrew Webb1

  • 1British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, St. Thomas' Hospital, Westminster bridge road, London SE1 7EH, UK.

European Heart Journal
|September 16, 2021
PubMed
Summary

Coronary microvascular disease (CMD) impairs blood flow in the heart, often seen in stable angina and heart failure with preserved ejection fraction (HFpEF). Understanding the CMD-HFpEF link is key to developing new treatments.

Keywords:
Coronary flow reserveCoronary microvascular diseaseHeart failure with preserved ejection fractionLusitropySubendocardial ischaemia

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Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
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Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Coronary microvascular disease (CMD), marked by reduced coronary flow reserve (CFR), is prevalent in stable angina.
  • Impaired CFR without obstructive coronary artery disease affects up to 75% of heart failure with preserved ejection fraction (HFpEF) patients.
  • HFpEF is a syndrome with diverse endotypes, and CMD is hypothesized to be central to the CMD-HFpEF endotype.

Purpose of the Study:

  • To review the pathophysiology of CMD.
  • To explore the mechanistic link between CMD and HFpEF.
  • To discuss clinical and research implications of the CMD-HFpEF connection.

Main Methods:

  • Literature review focusing on CMD pathophysiology.
  • Analysis of the mechanistic link between CMD and HFpEF.
  • Discussion of subendocardial ischemia and impaired lusitropy in CMD-HFpEF.

Main Results:

  • Subendocardial ischemia and impaired lusitropy are central to CMD-HFpEF development.
  • CMD is a key factor in a specific HFpEF endotype.
  • The CMD-HFpEF link has significant clinical and research implications.

Conclusions:

  • CMD plays a crucial role in the pathogenesis of the CMD-HFpEF endotype.
  • Further research and prospective studies are needed to understand CMD and HFpEF.
  • Physiology-stratified therapies targeting CMD-HFpEF could improve patient outcomes and quality of life.