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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: Inotropic Agents01:26

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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

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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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Ischemic Heart Disease: Overview01:17

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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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Related Experiment Video

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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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Using the 5Ms Framework to Advance Aging-Responsive Care for Heart Failure with Reduced Ejection Fraction.

Abigail Latimer1, Debra K Moser2, Jia-Rong Wu2

  • 1College of Social Work, University of Kentucky, Lexington, KY, 40506, USA.

Clinical Interventions in Aging
|March 25, 2025
PubMed
Summary

Older adults with heart failure with reduced ejection fraction (HFrEF) face complex care needs. The 5Ms Model offers a holistic approach to manage these challenges effectively.

Keywords:
cardiovascular diseaseframeworkinterdisciplinaryinterprofessionalolder adult

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Area of Science:

  • Geriatrics
  • Cardiology
  • Internal Medicine

Background:

  • Aging populations increase the complexity of managing chronic conditions like heart failure with reduced ejection fraction (HFrEF).
  • HFrEF presents unique challenges including unpredictable illness trajectories, risk of sudden cardiac death, and complex treatment requirements.
  • Managing HFrEF in older adults is further complicated by comorbidities, financial toxicity, mental health issues, and misaligned care preferences.

Purpose of the Study:

  • To present the 5Ms Model as a framework for optimizing the care of older adults with HFrEF.
  • To highlight the holistic approach of the 5Ms Model in addressing the multifaceted needs of this patient population.

Main Methods:

  • This is a narrative review.
  • The 5Ms Model (multicomplexity, mind, mobility, medications, and matters most) is discussed in the context of HFrEF care.
  • Existing applications of the 5Ms Model in other medical fields are considered.

Main Results:

  • The 5Ms Model provides a structured, holistic approach to gericare for HFrEF.
  • It addresses key domains impacting older adults with HFrEF: overall complexity, mental well-being, physical function, medication management, and patient-centered goals.
  • This model can guide generalist management, improving care alignment with patient values.

Conclusions:

  • The 5Ms Model offers a valuable framework for improving the comprehensive care of older adults with HFrEF.
  • Implementing this model can lead to more personalized and effective management strategies.
  • Further research may explore the direct impact of the 5Ms Model on clinical outcomes in HFrEF patients.