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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

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: 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...
309
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

354
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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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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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
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Heart Failure in Older Patients: An Update.

Massimo Montalto1,2, Federica D'Ignazio2, Sara Camilli2

  • 1Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, 00168 Rome, Italy.

Journal of Clinical Medicine
|March 27, 2025
PubMed
Summary
This summary is machine-generated.

Heart failure (HF) in older adults is a serious public health issue. Personalized management, considering comorbidities and frailty, is crucial for effective treatment and improved quality of life.

Keywords:
cardiovascular agingelderlyfrailtyheart failureolder patientspalliative care

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Area of Science:

  • Gerontology
  • Cardiology
  • Public Health

Background:

  • Heart failure (HF) is a prevalent condition in older adults, leading to high morbidity, mortality, and hospital admissions.
  • Older HF patients often present with comorbidities, frailty, malnutrition, and cachexia, complicating disease management.
  • Current treatment guidelines for older HF patients are limited, often extrapolated from trials not specifically designed for this demographic.

Purpose of the Study:

  • To provide an updated overview of the clinical, therapeutic, and prognostic aspects of acute and chronic heart failure in the elderly.
  • To highlight the challenges in diagnosing and managing HF in older populations.
  • To emphasize the importance of personalized treatment strategies and palliative care.

Main Methods:

  • Review of current literature and clinical trial data concerning HF in older adults.
  • Analysis of factors influencing HF management in the elderly, including comorbidities and frailty.
  • Discussion of pharmacological and non-pharmacological treatment approaches.

Main Results:

  • Standard pharmacological HF management is generally safe and well-tolerated in older adults.
  • A personalized approach is essential, considering comorbidities, overall health status, and prognosis.
  • Palliative care is integral to improving care and quality of life for elderly HF patients.

Conclusions:

  • Managing heart failure in older adults requires a tailored strategy due to increased risks of drug interactions and side effects.
  • Further research into novel pharmacological options is needed to optimize care for comorbid and frail elderly patients.
  • Integrating palliative care is vital for comprehensive HF management in the elderly.