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Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

1.5K
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: 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: 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: 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...
404
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

352
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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Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
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Clinical Update in Heart Failure with Preserved Ejection Fraction.

Chayakrit Krittanawong1, William Michael Britt2, Affan Rizwan3

  • 1Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY, USA. chayakrit.krittanawong@va.gov.

Current Heart Failure Reports
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Heart failure with preserved ejection fraction (HFpEF) affects half of heart failure patients. Recent studies highlight its complex pathology and the growing importance of managing cardiometabolic risk factors and comorbidities for effective treatment.

Keywords:
HFHFpEFHeart failure

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Heart failure with preserved ejection fraction (HFpEF) accounts for about 50% of heart failure cases.
  • HFpEF is linked to significant morbidity, mortality, and healthcare costs.
  • Effective treatment options for HFpEF remain less established compared to heart failure with reduced ejection fraction.

Purpose of the Study:

  • To provide a clinical update on heart failure with preserved ejection fraction (HFpEF).
  • To review recent clinical trials and data on HFpEF epidemiology, pathophysiology, diagnosis, and treatment.
  • To emphasize recent trends in cardiometabolic interventions for HFpEF.

Main Methods:

  • Review of recent clinical trials and epidemiological data.
  • Analysis of current understanding of HFpEF pathophysiology.
  • Evaluation of emerging treatment strategies, particularly cardiometabolic interventions.

Main Results:

  • HFpEF is a complex, heterogeneous syndrome.
  • Pathogenesis involves abnormal energetics, hypertrophy, cell signaling, inflammation, ischemia, and fibrosis.
  • Comorbidities like atrial fibrillation, CKD, hypertension, obesity, and CAD are intricately linked to HFpEF.

Conclusions:

  • Management of HFpEF requires strict regulation of comorbidities through pharmacologic and nonpharmacologic means.
  • Emerging insights into pathogenesis offer potential for novel therapies.
  • Cardiometabolic interventions represent a growing trend in HFpEF management.