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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 IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

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Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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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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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Sex-based differences in heart failure development during STEMI hospitalization.

Antonia Sambola1,2,3, Laia Milà1,3, Eduard Ródenas-Alesina1,3

  • 1Department of Cardiology, Hospital Universitari Vall d'Hebron, P° Vall d'Hebron 119-129, Barcelona 08035, Spain.

European Heart Journal. Quality of Care & Clinical Outcomes
|October 30, 2025
PubMed
Summary

Women with ST-segment elevation myocardial infarction (STEMI) admitted in Killip class I face a higher risk of developing heart failure (HF) during hospitalization. However, heart failure impacts mortality similarly in both sexes.

Keywords:
Heart failureMyocardial infarctionPrognosisSexWomen

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Area of Science:

  • Cardiology
  • Clinical Medicine
  • Sex Differences in Health

Background:

  • Sex-related differences in heart failure (HF) development post-ST-segment elevation myocardial infarction (STEMI) are not well understood.
  • This study investigates sex-specific HF incidence in STEMI patients initially classified as Killip class I.
  • The impact of in-hospital HF on mortality in this population is also evaluated.

Purpose of the Study:

  • To assess sex-specific differences in the development of in-hospital heart failure (HF) among ST-segment elevation myocardial infarction (STEMI) patients.
  • To evaluate the impact of in-hospital HF on mortality in STEMI patients admitted in Killip class I.
  • To identify factors associated with in-hospital HF development in this cohort.

Main Methods:

  • Analysis of prospective, multicenter registry data from six teaching hospitals.
  • Primary outcome: development of HF during hospitalization in Killip class I STEMI patients.
  • Secondary outcome: in-hospital mortality; multivariable logistic regression used to identify associated factors.

Main Results:

  • Among 985 Killip class I STEMI patients, 4.6% developed in-hospital HF, more frequently in women (7.9%) than men (3.6%).
  • Female sex (OR 3.09), multivessel disease (OR 2.19), and out-of-hospital cardiac arrest (OR 4.76) were independently associated with HF development.
  • Higher left ventricular ejection fraction was protective (OR 0.92); age and final TIMI flow <3 were not associated.

Conclusions:

  • Women with STEMI admitted in Killip class I exhibit a significantly higher risk of developing in-hospital heart failure.
  • Despite the increased risk of HF development in women, its impact on in-hospital mortality was comparable between sexes.
  • These findings highlight the importance of sex-specific considerations in managing STEMI patients at risk for heart failure.