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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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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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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 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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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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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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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

29
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

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Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
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Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
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Human Immunodeficiency Virus Infection-Associated Cardiomyopathy and Heart Failure.

Aikaterini Papamanoli1, Brandon Muncan2, Jeanwoo Yoo3

  • 1Internal Medicine, Zucker School of Medicine, Northwell Health at Mather Hospital, Port Jefferson, NY 11777, USA.

Journal of Personalized Medicine
|December 27, 2022
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Summary

Antiretroviral therapy (ART) improves outcomes for people with HIV (PLWH), but its long-term cardiovascular effects, including heart failure, are still being studied. Newer research questions traditional views on HIV-related heart disease in the ART era.

Keywords:
HAARTcardiomyopathyheart failurehuman immunodeficiency virus

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Human immunodeficiency virus (HIV) treatment has advanced significantly with antiretroviral therapy (ART).
  • People living with HIV (PLWH) now approach general population life expectancies, but cardiovascular health impacts require further investigation.
  • Historically, HIV-related cardiomyopathy and heart failure (HF) were linked to inflammation and cardiometabolic changes.

Purpose of the Study:

  • To investigate the evolving role of ART in HIV-related cardiomyopathy and heart failure.
  • To examine the changing phenotypes of HIV-related heart disease in the context of modern treatment.
  • To understand the complex interplay between HIV, ART, and cardiovascular outcomes.

Main Methods:

  • Review of current literature on HIV epidemiology, ART, and cardiovascular health.
  • Analysis of emerging data on long-term cardiovascular outcomes associated with specific ART regimens.
  • Exploration of recent findings linking HIV-related HF with other clinical conditions like depression.

Main Results:

  • While newer ART regimens may offer short-term cardioprotection, long-term use of certain drugs (e.g., protease inhibitors) raises concerns for cardiovascular adverse effects.
  • Traditional phenotypes of HIV-related heart disease are shifting from dilated cardiomyopathy to increased rates of diastolic dysfunction and ischemic heart disease.
  • Significant associations between HIV-related HF and conditions like depression complicate cardiac care for PLWH.

Conclusions:

  • The traditional understanding of HIV-related cardiomyopathy and HF is being challenged by the evolving landscape of ART.
  • Optimal strategies for preventing and treating heart conditions in PLWH require ongoing investigation.
  • The long-term cardiovascular implications of ART and the mechanisms of HIV-related myocardial damage remain critical areas for research.