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Related Concept Videos

Exercise Stress Test01:26

Exercise Stress Test

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Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
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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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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

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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...
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Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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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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Increased pulse rate01:17

Increased pulse rate

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Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
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Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

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Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
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Implantation of the Syncardia Total Artificial Heart
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Your Heart Function Has Normalized-What Next After TRED-HF?

Alexandros Kasiakogias1, Aaraby Ragavan1,2, Brian P Halliday3,4

  • 1Inherited Cardiac Conditions Care Group, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, London, UK.

Current Heart Failure Reports
|November 24, 2023
PubMed
Summary
This summary is machine-generated.

Heart failure therapy is increasing ejection fraction normalization. Remission, not full recovery, is typical for dilated cardiomyopathy patients, highlighting the need for ongoing management strategies.

Keywords:
Dilated cardiomyopathyDrug withdrawalHeart failureImproved ejection fractionRecovered ejection fraction

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Area of Science:

  • Cardiology
  • Heart Failure Research
  • Pharmacology

Background:

  • Contemporary disease-modifying heart failure therapies are improving ejection fraction normalization rates.
  • The TRED-HF trial indicates heart failure remission is more common than complete recovery in responding patients with dilated cardiomyopathy.
  • A growing cohort of patients with normalized ejection fraction presents unique management challenges.

Purpose of the Study:

  • To review key management strategies for patients with normalized ejection fraction.
  • To identify knowledge gaps in the care of this patient population.
  • To focus on non-ischaemic dilated cardiomyopathy within this context.

Main Methods:

  • Review of current literature on heart failure therapy and outcomes.
  • Analysis of findings from trials like TRED-HF.
  • Discussion of advanced diagnostic and therapeutic approaches.

Main Results:

  • Significant heterogeneity exists among patients with normalized ejection fraction, influenced by etiology and genetic susceptibility.
  • Ongoing pathophysiological processes can be elucidated using advanced cardiac imaging, biomarkers, multi-omics, and machine learning.
  • Diuretics may be withdrawn if congestion is absent, but continued disease-modifying therapy is often necessary to sustain remission.

Conclusions:

  • Understanding the underlying mechanisms in patients with normalized ejection fraction is vital for predicting relapse and personalizing therapy.
  • Comprehensive characterization is needed to identify multifactorial disease phenotypes.
  • Future personalized treatment approaches will be informed by ongoing clinical trials.