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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

16
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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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 V: Medical Management01:30

Heart Failure V: Medical Management

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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...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

470
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...
470
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

21
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 Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

392
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Related Experiment Video

Updated: Jul 27, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

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

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Sympathomodulation in Heart Failure with High vs. Normal Ejection Fraction.

Karl Fengler1, Karl-Patrik Kresoja1, Karl-Philipp Rommel1

  • 1Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.

Structural Heart : the Journal of the Heart Team
|June 8, 2023
PubMed
Summary

Renal denervation (RDN) shows promise for heart failure with preserved ejection fraction (HFpEF), with distinct effects observed in high ejection fraction (HEF) and normal ejection fraction (NEF) groups. Further research into sympathomodulatory treatments for HFpEF is warranted.

Keywords:
Heart failure with preserved ejection fractionSingle-beat estimationSympathomodulation

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Area of Science:

  • Cardiology
  • Nephrology
  • Biomedical Engineering

Background:

  • Heart failure with preserved ejection fraction (HFpEF) has limited treatment options and poor outcomes.
  • Sodium glucose linked transporter 2 inhibitors show minimal benefit in high ejection fraction (HEF) HFpEF patients.
  • HFpEF may involve distinct biomechanical and cellular phenotypes based on ejection fraction (EF) ranges (HEF vs. normal EF [NEF]).

Purpose of the Study:

  • To investigate distinct HFpEF phenotypes in HEF and NEF groups using noninvasive single-beat estimations.
  • To assess alterations in pressure-volume relations following renal denervation (RDN) in both HEF and NEF HFpEF patients.

Main Methods:

  • Stratification of HFpEF patients into HEF (>60% EF) and NEF (50%-60% EF) groups from a prior RDN study.
  • Utilized single-beat estimations to derive arterial elastance (Ea), end-systolic elastance (Ees), and diastolic capacitance (VPED20).

Main Results:

  • Arterial elastance (Ea) was similar between groups and decreased post-RDN in both.
  • End-systolic elastance (Ees) was higher and diastolic capacitance (VPED20) lower in HEF vs. NEF.
  • Ees and VPED20 changed significantly post-RDN in HEF but not NEF; Ees/Ea increased in NEF post-RDN but not in HEF.

Conclusions:

  • Renal denervation (RDN) demonstrated beneficial effects in both NEF and HEF HFpEF patient groups.
  • Findings support further investigation of sympathomodulatory therapies for HFpEF.
  • Distinct HFpEF phenotypes may respond differently to interventions, necessitating tailored treatment approaches.