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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 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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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

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Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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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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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
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Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure.

Jennifer M Coller1, Fei Fei Gong1,2,3, Michele McGrady4

  • 1St. Vincent's Hospital, Melbourne, Victoria, Australia.

ESC Heart Failure
|December 1, 2021
PubMed
Summary

Identifying risk factors for asymptomatic heart abnormalities is key to preventing heart failure (HF). Different factors influence structural, systolic, and diastolic changes, offering unique pathways to symptomatic HF.

Keywords:
Diastolic abnormalityEchocardiographyRisk factorsStructural abnormalitySystolic abnormality

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Area of Science:

  • Cardiology
  • Preventive Medicine
  • Echocardiography

Background:

  • Asymptomatic echocardiographic abnormalities precede symptomatic heart failure (HF).
  • Understanding early HF pathogenesis requires identifying risk factors for these abnormalities.
  • The SCReening Evaluation of the Evolution of New HF (SCREEN-HF) study provides a community-based cohort for this research.

Purpose of the Study:

  • To examine risk factors for asymptomatic echocardiographic structural, systolic, and diastolic abnormalities.
  • To investigate interactions between these risk factors.
  • To gain insights into early mechanisms of HF pathogenesis and inform prevention strategies.

Main Methods:

  • Prospective analysis of 3190 participants at increased cardiovascular disease risk.
  • Logistic regression used to identify risk factors for isolated and combined echocardiographic abnormalities.
  • Defined structural, systolic, and diastolic abnormalities using established criteria.

Main Results:

  • Increased BMI, NSAID use, and alcohol intake linked to structural abnormalities.
  • Male gender, higher heart rate, AF, ACE inhibitor use, and OSA linked to lower risk of structural abnormalities.
  • Male gender, smoking, higher SBP, and inactivity linked to systolic abnormalities; higher pulse pressure and antihypertensive therapy linked to lower risk.
  • Increased age, BP, NT-proBNP, and warfarin use linked to diastolic abnormalities; higher heart rate and triglycerides linked to lower risk.
  • Interactions between risk factors varied across abnormality types.

Conclusions:

  • Distinct risk factor profiles for structural, systolic, and diastolic abnormalities highlight unique HF development pathways.
  • Understanding these trajectories is crucial for developing targeted HF prevention strategies.
  • Early identification and management of specific risk factors can potentially alter disease progression.