Related Experiment Video
Updated: Aug 28, 2025
09:20
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
6.6K
A Holistic View of Advanced Heart Failure
Filippos Triposkiadis1, Grigorios Giamouzis1, Takeshi Kitai2
1Department of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece.
Life (Basel, Switzerland)
|September 23, 2022
Summary
Advanced heart failure (HF) management requires better metrics beyond ejection fraction. Novel indices and expanded treatment options are crucial for improving outcomes in HF patients.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Heart Failure Research
Background:
- Advanced heart failure (HF) presents across all ejection fraction levels.
- Left ventricular ejection fraction (LVEF) is influenced by heart size and geometry, limiting its accuracy.
- Accurate assessment of ventricular function and size is critical for guiding HF treatment.
Purpose of the Study:
- To highlight the limitations of LVEF in advanced HF.
- To advocate for supplementary or alternative indices for evaluating LV function and size.
- To address challenges in advanced HF treatments like mechanical circulatory support (MCS) and heart transplantation (HTx).
Main Methods:
- Review of current practices in advanced HF evaluation and treatment.
- Discussion of limitations of Left Ventricular Ejection Fraction (LVEF).
- Exploration of alternative indices: systolic strain, cardiac power output, LV diastolic diameters, and volumes.
Main Results:
- LVEF is insufficient for comprehensive assessment in advanced HF.
- Systolic strain and cardiac power output offer more specific functional insights.
- LV diastolic diameters and volumes provide better size evaluation.
- Current advanced treatments (MCS, HTx) face limitations related to heart size and donor availability.
Conclusions:
- LVEF should be supplemented or replaced by more specific indices in advanced HF.
- Expanding indications for MCS in smaller ventricles is a key challenge.
- Increasing the heart transplant donor pool is essential for managing advanced HF.
Related Concept Videos
01:17Pathophysiology of Heart Failure
1.8K
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...
1.8K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
27
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...
27
01:29Heart Failure II: Pathophysiology
31
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...
31
01:27Heart Failure I: Introduction
44
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...
44
01:22Heart Failure VI: Adjunct Therapies
25
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.
25
01:30Heart Failure VII: Nursing Interventions
131
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
131