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Related Concept Videos

Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

22
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.
22
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 Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

481
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
481
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

440
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
440
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

20
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 VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

130
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,...
130

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Related Experiment Video

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Isolation of Atrial Myocytes from Adult Mice
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Natriuretic Peptide-guided Therapy for Heart Failure.

Yu Horiuchi1, Humberto Villacorta2, Alan S Maisel3

  • 1Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Chiyoda City, Kanda Izumicho, Japan.

Heart International
|February 6, 2023
PubMed
Summary

Natriuretic peptide (NP)-guided therapy may benefit heart failure with reduced ejection fraction (HFrEF) patients, particularly those under 75. However, NP guidance shows no benefit in HF with preserved ejection fraction (HFpEF) or acute heart failure settings.

Keywords:
Natriuretic peptidesheart failurepreventionprognosistherapy

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Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Trials

Background:

  • Heart failure (HF) presents significant mortality and hospitalization challenges.
  • Current HF management relies on clinical assessment, with natriuretic peptides (NPs) as key diagnostic and prognostic biomarkers.
  • NPs, including B-type natriuretic peptide (BNP) and N-terminal proBNP, are crucial for HF diagnosis and prognosis, guiding therapy adjustments.

Purpose of the Study:

  • To evaluate the efficacy of natriuretic peptide (NP)-guided therapy in managing heart failure (HF).
  • To determine if NP-guided therapy improves outcomes in different HF subtypes and clinical settings.
  • To assess the role of NP-guided therapy in preventing HF development.

Main Methods:

  • Review of clinical trials investigating NP-guided therapy versus conventional care in HF patients.
  • Analysis of outcomes including cardiac events, mortality, and HF progression across various HF populations.
  • Stratification of results based on ejection fraction (HFrEF vs. HFpEF) and acute vs. chronic settings.

Main Results:

  • NP-guided therapy showed potential benefits in heart failure with reduced ejection fraction (HFrEF), particularly reducing mortality in patients under 75 years.
  • Conflicting results were observed in HFrEF studies (e.g., STARS-BNP, PROTECT, BATTLESCARRED, TIME-CHF vs. PRIMA, GUIDE-IT).
  • No significant differences were found with NP-guided therapy in HF with preserved ejection fraction (HFpEF) or acute HF settings. NP guidance may aid in preventing HF in at-risk individuals.

Conclusions:

  • NP-guided therapy appears beneficial for HFrEF patients, especially younger individuals (<75 years).
  • NP-guided therapy is not effective in HFpEF or acute HF management.
  • NPs can be valuable for guiding therapy and preventing HF in at-risk populations.