Heart failure

2010 ◽  
pp. 3-28
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Heart Failure ◽  
Clinical Trials ◽  
Chronic Heart Failure ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Heart Failure ◽  
The Body ◽  
Pharmacological Management ◽  
Reduced Ejection Fraction ◽  
Structural Abnormalities

Introduction 4 Chronic heart failure with reduced LVEF (systolic heart failure) 6 Pharmacological management of chronic heart failure 8 Non-pharmacological management of chronic heart failure 18 Chronic heart failure with preserved LVEF (diastolic heart failure) 20 Acute heart failure 22 Clinical trials 26 Heart failure (HF) is a complex condition that results from cardiac functional and/or structural abnormalities that affect the ability of the heart to pump blood, and is often defined as the inability of the heart to adequately perfuse the organs of the body. Symptoms of HF vary depending on several factors but the most common manifestations of HF are dyspnoea and fatigue. Of importance, HF is not necessarily associated with a reduced ejection fraction (EF) (systolic HF), as up to 50% of cases occur in the presence of a preserved systolic function (diastolic dysfunction)....

scholarly journals Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Kazuo Komamura
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Low Cardiac Output ◽  
Reduced Ejection Fraction ◽  
Similarities And Differences ◽  
Ventricular Filling

Pathophysiology of heart failure has been considered to be a damaged state of systolic function of the heart followed by a state of low cardiac output that is, systolic heart failure. Even if systolic function is preserved, left ventricular filling in diastole can be impeded and resulted in elevation of filling pressure and symptoms of heart failure. This kind of heart failure is called diastolic heart failure. Nowadays, diastolic heart failure is referred to as heart failure with preserved ejection fraction (HFpEF), whereas systolic heart failure is referred to as heart failure with reduced ejection fraction (HFrEF). In this paper, the similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure were reviewed. Although diastolic heart failure is a common condition of heart failure worldwide, its pathophysiology has not been sufficiently elucidated. This is thought to be the most significant reason for a lack of established treatment methods for diastolic heart failure. We hope to proceed with future studies on this topic.

scholarly journals Comparative evaluation of speckle tracking echocardiography technologies in twodimensional and three-dimensional modes in patients with chronic heart failure with preserved and reduced systolic function of the left ventricle

2020 ◽  
pp. 64-71
Author(s):  
М.А. САИДОВА ◽  
В.Х. СОХИБНАЗАРОВА ◽  
А.А. АВАЛЯН ◽  
С.Н. ТЕРЕЩЕНКО
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Three Dimensional ◽  
Diagnostic Significance ◽  
Reduced Ejection Fraction ◽  
Deformation Properties

Резюме В исследование включены 70 больных с хронической сердечной недостаточностью (ХСН) с сохранной и сниженной фракцией выброса (ФВ) левого желудочка (ЛЖ). Всем больным проводили стандартную трансторакальную эхокардиографию (ЭхоКГ) с тканевой миокарди3 альной допплерографией. Для оценки деформационных свойств миокарда ЛЖ применяли технологию спекл3трекинг ЭхоКГ в двухмер3 ном и трехмерном режимах. Сравнительный анализ показал, что параметры деформации миокарда ЛЖ у больных ХСН как с сохранной, так и со сниженной ФВ ЛЖ в трехмерном режиме спекл3трекинг ЭхоКГ были ниже, чем в двухмерном. Два метода тесно коррелировали между собой при расчете показателей деформационных свойств как продольных, так и циркулярных волокон миокарда ЛЖ. ROC3анализ показал диагностическую значимость параметра площади деформации у больных ХСН как с сохранной, так и со сниженной ФВ ЛЖ. При проведении анализа воспроизводимости отмечено, что трехмерный режим спекл3трекинг ЭхоКГ имеет меньшую внутриоператорскую и межоператорскую ошибку, а также занимает меньше времени на обработку изображений. Summary The study included 70 patients with chronic heart failure (CHF) with a preserved and reduced ejection fraction of the left ventricle (LVEF). All patients underwent standard transthoracic echocardiography with tissue myocardial dopplerography technology and speckle3tracking echocardiography in two and three dimensional modes. A comparative analysis showed that the parameters of LV deformation in patients with CHF with preserved and reduced LVEF in three3dimensional mode speckle tracking echocardiography were lower than in two3dimensional. Two methods were correlated with each other in calculating the deformation properties of both longitudinal and circular LV myocardial fibers. ROC analysis showed the diagnostic significance of the global area strain in patients with CHF with intact and with reduced LVEF. When conducting a reproducibility analysis, it was noted that the three3dimensional speckle tracking echocardiography mode has less intra3operator and inter3operator error, and also takes less time to process images.

Applying Fractal Dimension and Image Analysis to Quantify Fibrotic Collagen Deposition and Organization in the Normal and Hypertensive Heart

2014 ◽  
Vol 20 (4) ◽  
pp. 1134-1144 ◽  
Author(s):  
Fouad A. Zouein ◽  
Mazen Kurdi ◽  
George W. Booz ◽  
John W. Fuseler
Keyword(s):  
Heart Failure ◽  
Image Analysis ◽  
Fractal Dimension ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Quantitative Description ◽  
Systolic Heart Failure ◽  
Cellular Protein ◽  
Matrix Deposition ◽  
Extracellular Matrix Deposition

AbstractHearts of mice with reduction of function mutation in STAT3 (SA/SA) develop fibrotic collagen foci and reduced systolic function with hypertension. This model was used to determine if fractal dimension and image analysis can provide a quantitative description of myocardial fibrosis using routinely prepared trichome-stained material. Collagen was characterized by relative density [integrated optical density/area (IOD/A)] and fractal dimension (D), an index of complexity. IOD/A of collagen in wild type mice increased with hypertension while D decreased, suggesting tighter collagen packing that could eventually stiffen the myocardium as in diastolic heart failure. Reduced STAT3 function caused modest collagen fibrosis with increased IOD/A and D, indicating more tightly packed, but more disorganized collagen than normotensive and hypertensive controls. Hypertension in SA/SA mice resulted in large regions where myocytes were lost and replaced by fibrotic collagen characterized by decreased density and increased disorder. This indicates that collagen associated with reparative fibrosis in SA/SA hearts experiencing hypertension was highly disorganized and more space filling. Loss of myocytes and their replacement by disordered collagen fibers may further weaken the myocardium leading to systolic heart failure. Our findings highlight the utility of image analysis in revealing importance of a cellular protein for normal and reparative extracellular matrix deposition.

scholarly journals Does Platelet and Inflammatory Readings Differ Between Chronic Heart Failure Patients‘ Groups According to NYHA Functional Classes?

2019 ◽  
Vol 2 (4) ◽  
pp. e00111
Author(s):  
Aušra Mongirdienė ◽  
Jolanta Laukaitienė ◽  
Vilius Skipskis
Keyword(s):  
Heart Failure ◽  
New York ◽  
Platelet Aggregation ◽  
Chronic Heart Failure ◽  
Nyha Class ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
Fibrinogen Concentration ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients

It is stated in the literature that thrombosis in the chronic heart failure (CHF) patients may be caused by interaction of inflammation and platelets. The incidence of venous thromboembolism in heart failure patients is found to be the highest in the patients classified as NYHA IV. We aimed to test the hypothesis that prothrombotic state depends on inflammation. We have compared the C-reactive protein (CRP), fibrinogen concentration, platelet count (PLT), mean platelet volume (MPV) and platelet aggregation in CHF patients’ groups according to New York Heart Association (NYHA). 203 patients with CHF with reduced ejection fraction (systolic heart failure classes I‒IV according to NYHA) were included in the study. There were no statistically significant differences in fibrinogen concentration, CRP, PLT and platelet aggregation between the groups according to NYHA. The MPV was statistically significant higher in NYHA IV group than in NYHA III, NYHA II and NYHA I groups (10.86 ± 1.14 and 9.78 ± 1.21 and 9.65 ± 1.22 and 9.21 ± 0.59 respectively, p = 0.006). There was a weak correlation between CRP and PLT (r = 0.293, p = 0.010), and between MPV and fibrinogen concentration (r=0.205, p=0.012). There was a moderate correlation between MPV and NYHA (r = 0.361, p < 0.001) and between fibrinogen concentration and CRP (r = 0.381, p < 0.001). MPV rising in the patients’ groups and correlation between MPV and NYHA class, and plasma fibrinogen concentration, correlation between PLT and CRP, correlation between CRP and NT-proBNP concentration confirm, that low inflammation can take place in the MPV rising.

scholarly journals Pharmacological Treatment of Patients with Chronic Systolic Heart Failure

2014 ◽  
Vol 9 (1) ◽  
pp. 43
Author(s):  
Christoph Maack ◽  
Michael Böhm ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Pharmacological Treatment ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
The Body ◽  
Peripheral Tissues ◽  
Patients With Heart Failure ◽  
Chronic Systolic Heart Failure ◽  
Neuroendocrine Activation

Chronic heart failure is characterised by neuroendocrine activation as an attempt of the body to maintain pump function of the heart and blood pressure for the perfusion of peripheral tissues. While this neuroendocrine activation is beneficial in the short term, it induces maladaptive remodeling of the heart with continuous deterioration of left ventricular function. Accordingly, pharmacological treatment of patients with heart failure aims at protecting the heart from this neuroendocrine activation, which is represented in particular by the sympathetic nervous and the renin-angiotensin-aldosterone systems. While this concept is based on evidence from numerous large randomised placebo-controlled studies in patients with systolic heart failure, about half of the patients with heart failure have preserved systolic function, and most studies antagonising neuroendocrine activation were not successful in these latter patients. Here, we review the pathophysiological changes that occur in patients with heart failure and provide an overview on the mechanisms and clinical evidence of currently applied pharmacological treatment in patients with systolic heart failure.

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