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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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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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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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Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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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: Diuretics01:22

Heart Failure Drugs: Diuretics

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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...
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Related Experiment Video

Updated: Jun 25, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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[Heart failure with preserved left ventricular ejection fraction (HFpEF)].

Micha T Maeder1, Hans Rickli2, Eva Scheler2

  • 1Klinik für Kardiologie, Kantonsspital St. Gallen, St. Gallen, micha.maeder@kssg.ch.

Therapeutische Umschau. Revue Therapeutique
|May 23, 2024
PubMed
Summary

Heart failure with preserved ejection fraction (HFpEF) management is revolutionized by Sodium Glucose cotransporter-2 inhibitors. This overview details HFpEF pathophysiology, diagnostics, and treatment strategies for improved patient outcomes.

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Last Updated: Jun 25, 2025

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart failure with preserved ejection fraction (HFpEF) is a significant clinical challenge associated with high hospitalization and mortality rates.
  • Key pathophysiological features include concentric left ventricular remodeling, impaired compliance, and left atrial dysfunction, leading to elevated pressures and reduced exercise tolerance.

Purpose of the Study:

  • To provide a comprehensive overview of the current understanding of HFpEF pathophysiology.
  • To outline diagnostic principles and summarize intervention studies.
  • To propose a practical treatment approach for HFpEF.

Main Methods:

  • Review of current literature on HFpEF pathophysiology and diagnostics.
  • Analysis of key clinical trial results, particularly Sodium Glucose cotransporter-2 inhibitors (SGLT-2 inhibitors).
  • Synthesis of information to propose a clinical treatment strategy.

Main Results:

  • Sodium Glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have demonstrated a revolutionary impact on HFpEF treatment.
  • Understanding of HFpEF pathophysiology, diagnostic pathways, and treatment options has significantly advanced.

Conclusions:

  • HFpEF requires a complex diagnostic approach, but recent advancements have improved understanding.
  • SGLT-2 inhibitors represent a major therapeutic breakthrough for HFpEF.
  • A structured approach integrating pathophysiology, diagnostics, and evidence-based treatments is crucial for effective HFpEF management.