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Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

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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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Cardiomyopathy I: Introduction and Classification01:25

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Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
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Heart Failure II: Pathophysiology01:29

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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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Aortic Regurgitation III: Medical Management01:25

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Related Experiment Video

Updated: Mar 9, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Reclassifying Left Ventricular Diastolic Function with the 2025 American Society of Echocardiography Guideline versus

Abdelrahman Hafez1, Juan M Farina1, Sherif Ahmed1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 7, 2026
PubMed
Summary
This summary is machine-generated.

The 2025 American Society of Echocardiography diastolic guideline removes the indeterminate category, offering clearer risk stratification. However, its prognostic discrimination for heart failure hospitalization and mortality remains similar to the 2016 guideline.

Keywords:
ASE/EACVI guidelinesDiastolic dysfunctionEchocardiographyLeft atrial strainLeft ventricular filling pressure

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Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Guidelines

Background:

  • The 2025 American Society of Echocardiography (ASE) diastolic guideline updates the 2016 ASE/EACVI algorithm.
  • It incorporates outcome-anchored thresholds and left atrial (LA) strain.
  • This may alter diastolic grading and prognostic classification.

Purpose of the Study:

  • Quantify reclassification between the 2016 and 2025 ASE diastolic algorithms.
  • Compare outcomes-based risk stratification for 1-year heart failure (HF) hospitalization and all-cause mortality.
  • Evaluate risk across diastolic grades and filling-pressure categories.

Main Methods:

  • Applied both 2016 and 2025 ASE diastolic guidelines to echocardiographic data from 5,907 patients.
  • Analyzed 1-year HF hospitalization and all-cause mortality.
  • Used Kaplan-Meier methods and Cox models for outcome associations; C-index for discrimination.

Main Results:

  • The 2025 guideline eliminated the indeterminate diastolic category, shifting classifications.
  • High versus low filling pressure was associated with higher risk for HF hospitalization and mortality under both guidelines.
  • Prognostic discrimination for HF hospitalization was comparable between the 2016 (C-index 0.65) and 2025 (C-index 0.64) frameworks.

Conclusions:

  • The 2025 ASE algorithm provides clearer, stepwise risk stratification by removing the indeterminate category.
  • Overall prognostic discrimination for clinical outcomes using filling-pressure classification is similar to the 2016 framework.
  • The updated guideline enhances clarity in diastolic assessment.