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Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

1.7K
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...
1.7K
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

31
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...
31
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...
20
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

24
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...
24
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

19
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
19
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

31
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...
31

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Updated: Aug 11, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

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Misconceptions and Facts about Heart Failure with Reduced Ejection Fraction.

Chayakrit Krittanawong1, Mario Rodriguez2, Matthew Lui2

  • 1Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY.

The American Journal of Medicine
|February 5, 2023
PubMed
Summary

Understanding heart failure with reduced ejection fraction (HFrEF) is crucial. Key therapies target underlying causes, not just ejection fraction, and should continue even with congestion or improved LVEF.

Keywords:
Cardiac AmyloidosisDisease ProgressionGuideline directed medical therapyHeart failure with reduced ejection fractionLeft ventricular dysfunctionMisconceptionsNatriuretic Peptides

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart failure with reduced ejection fraction (HFrEF) significantly contributes to morbidity and mortality.
  • Common misconceptions exist regarding HFrEF pathophysiology and optimal treatment strategies.
  • HFrEF and left ventricular systolic dysfunction are distinct clinical entities.

Purpose of the Study:

  • To clarify common misconceptions surrounding heart failure with reduced ejection fraction.
  • To emphasize the importance of targeting underlying disease processes in HFrEF therapy.
  • To provide guidance on best practices for managing HFrEF, including during acute exacerbations.

Main Methods:

  • This review addresses common clinical misconceptions about heart failure with reduced ejection fraction.
  • It synthesizes current understanding of HFrEF pathophysiology and treatment.

Main Results:

  • Heart failure with reduced ejection fraction and left ventricular systolic dysfunction are not interchangeable.
  • Therapies for HFrEF should address underlying disease processes, not solely ejection fraction.
  • Absence of congestion does not exclude heart failure; cardiac amyloidosis can present as HFrEF.
  • Rising creatinine in acute exacerbations is not linked to tubular injury.
  • Guideline-directed medical therapy (GDMT) is essential during acute HFrEF exacerbations and new diagnoses, even with marginal blood pressure or improved ejection fraction.

Conclusions:

  • Effective HFrEF management requires understanding its distinct pathophysiology.
  • Guideline-directed medical therapy is paramount and should be initiated promptly and continued consistently.
  • Beyond the four foundational medications, other beneficial therapies exist for HFrEF management.