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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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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: 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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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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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Gut Hormones in Heart Failure.

Tania Deis1, Jens P Goetze2,3, Caroline Kistorp4,5

  • 1Department of Cardiology (T.D., F.G.), Rigshospitalet, Copenhagen, Denmark.

Circulation. Heart Failure
|November 5, 2024
PubMed
Summary

Gut hormones like GLP-1 impact heart function and may offer protection in heart failure (HF). Altered gut hormone levels in HF patients suggest a significant role in cardiac pathology and potential therapeutic targets.

Keywords:
gastrointestinal hormonesheartheart failurehemodynamicsmyocardium

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Area of Science:

  • Cardiology
  • Endocrinology
  • Gastroenterology

Background:

  • Heart failure (HF) affects multiple organ systems, with the gut-heart axis increasingly recognized.
  • The role of gastrointestinal (GI) hormones in cardiac function and HF pathophysiology is an emerging area of research.
  • Existing research has focused on cardiorenal interactions, leaving the endocrine gut's role in HF less explored.

Purpose of the Study:

  • To review current knowledge on gut hormones in heart failure, particularly HF with reduced ejection fraction.
  • To explore the regulatory roles of gut hormones in cardiac function and central hemodynamics.
  • To discuss potential therapeutic strategies and identify knowledge gaps concerning gut hormones in HF.

Main Methods:

  • Literature review of studies investigating gut hormones and heart failure.
  • Analysis of evidence on specific gut hormones, such as glucagon-like peptide-1 (GLP-1), and their cardiac effects.
  • Examination of altered gut hormone bioavailability in HF patients and its prognostic implications.

Main Results:

  • Glucagon-like peptide-1 (GLP-1) demonstrates direct cardiac effects, influencing heart rate, contractility, and potentially offering cardioprotection.
  • Other gut hormones may possess cardiostimulatory properties, contributing to cardiac function.
  • HF patients exhibit altered bioavailability of various GI hormones, suggesting prognostic significance.

Conclusions:

  • Gut hormones play a crucial role in cardiac physiology and pathology, especially in the failing heart.
  • Understanding the gut-heart axis offers novel insights into HF mechanisms.
  • Targeting gut hormones presents a promising therapeutic avenue for managing heart failure.