Myocardial Hypertrophy and Heart Failure Quiz

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Questions and Answers

What is the key structural change in myocardial concentric hypertrophy?

In myocardial concentric hypertrophy, there is an increased diameter of myocardial fiber and enhanced wall thickness due to sarcomeres arranged in parallel.

How does eccentric hypertrophy differ from concentric hypertrophy?

Eccentric hypertrophy involves increased internal chamber size and decreased wall thickness, with sarcomeres arranged in series due to volume overload.

What physiological response occurs due to increased blood volume?

Increased blood volume leads to decreased glomerular filtration rate (GFR) and promotes water and sodium retention.

What role does erythropoietin (EPO) play in myocardial hypertrophy?

<p>EPO is released by the kidney in response to poor cardiac output, leading to increased production of red blood cells.</p> Signup and view all the answers

How does the body redistribute blood flow during myocardial hypertrophy?

<p>Blood flow is prioritized to vital organs through sympathetic activation and catecholamine release, resulting in vasoconstriction in non-essential areas.</p> Signup and view all the answers

Describe the change in cellular function in response to increased tissue capability to utilize oxygen.

<p>There is an alteration in cellular metabolism and structure, enhancing the capability of cells to utilize oxygen effectively.</p> Signup and view all the answers

What is one consequence of excessive water and sodium retention due to heart overload?

<p>Excessive retention leads to general edema as the volume load on the heart increases.</p> Signup and view all the answers

What mechanisms are involved in the compensatory response to myocardial hypertrophy?

<p>Neurohumoral mechanisms, including hormonal responses and changes in blood flow dynamics, are involved in the compensation for myocardial hypertrophy.</p> Signup and view all the answers

What role does myocardial contraction impairment play in heart failure?

<p>Myocardial contraction impairment leads to depressed contractility, which can arise from destruction of myocardium and dysfunction of excitation-contraction coupling.</p> Signup and view all the answers

Identify two causes of myocardial destruction that contribute to heart failure.

<p>Two causes of myocardial destruction are ischemia and reactive oxygen species (ROS).</p> Signup and view all the answers

How does a myocardial infarction impact the risk of heart failure?

<p>A myocardial infarction that affects over 23% of the left ventricle increases the risk of heart failure, while over 40% can lead to cardiogenic shock.</p> Signup and view all the answers

What is ventricular remodeling, and how can it contribute to heart failure?

<p>Ventricular remodeling includes myocardial hypertrophy and dilation, which may initially compensate for cardiac insufficiency but can ultimately lead to heart failure if excessive.</p> Signup and view all the answers

List one cytokine involved in myocardial damage and explain its effect.

<p>Tumor necrosis factor-alpha (TNF-α) is a cytokine that contributes to myocardial damage by promoting inflammation and apoptosis in cardiac tissue.</p> Signup and view all the answers

What is the significance of delayed repositioning of Ca2+ in relation to diastolic dysfunction?

<p>It leads to impaired ventricular relaxation and contributes to reduced compliance during diastole.</p> Signup and view all the answers

What characterizes acute heart failure in terms of cardiac output?

<p>Acute heart failure is characterized by rapid onset and a sharp decrease in cardiac output.</p> Signup and view all the answers

What is the difference between left heart failure and right heart failure?

<p>Left heart failure leads to pulmonary circulatory congestion, while right heart failure causes systemic circulatory congestion.</p> Signup and view all the answers

How does impaired dissociation of the myosin-actin complex affect cardiac function?

<p>It decreases the efficiency of muscle contraction, leading to inadequate ventricular filling during diastole.</p> Signup and view all the answers

Explain how decreased potential energy during ventricular diastole contributes to diastolic dysfunction.

<p>Lower potential energy reduces the heart's capacity to fill properly, limiting blood volume for effective circulation.</p> Signup and view all the answers

What conditions are associated with low-output heart failure?

<p>Low-output heart failure is associated with conditions like coronary heart disease, hypertension, and valvular disease.</p> Signup and view all the answers

Describe the concept of ventricular compliance and its relation to diastolic dysfunction.

<p>Ventricular compliance refers to the heart's ability to stretch and fill; reduced compliance impairs this process, leading to insufficient filling.</p> Signup and view all the answers

In what scenario would high-output heart failure occur?

<p>High-output heart failure occurs in hyperdynamic circulatory states where there is excessive body demand for perfusion.</p> Signup and view all the answers

What are the key manifestations of low output syndrome in cardiac insufficiency?

<p>The main manifestations include decreased cardiac output, altered arterial blood pressure, and blood redistribution.</p> Signup and view all the answers

What differentiates systolic heart failure from diastolic heart failure?

<p>Systolic heart failure is characterized by a reduced ability of the heart to contract, while diastolic heart failure involves impaired filling of the heart.</p> Signup and view all the answers

According to the New York Heart Association (NYHA) classification, what class is assigned to mild heart failure?

<p>Mild heart failure is classified as Class I/II, indicating complete compensation.</p> Signup and view all the answers

Identify the features associated with moderate heart failure.

<p>Moderate heart failure is characterized by incomplete compensation, classified as Class III.</p> Signup and view all the answers

What is the primary mechanism of cardiac compensation in response to increased heart failure?

<p>Increased heart rate is the primary compensatory mechanism.</p> Signup and view all the answers

How do catecholamines affect myocardial contractility?

<p>Catecholamines enhance myocardial contractility by opening receptor-operated Ca2+ channels, which increases calcium influx.</p> Signup and view all the answers

What role does myocardial remodeling play in chronic heart failure?

<p>Myocardial remodeling in chronic heart failure involves compensatory mechanisms such as increased blood volume to maintain cardiac output.</p> Signup and view all the answers

Describe the Frank-Starling law of the heart.

<p>The Frank-Starling law states that myocardial contractility increases with the initial length of the muscle fibers within a certain optimal range.</p> Signup and view all the answers

What factors stimulate the sympathetic nervous system in cardiac insufficiency?

<p>Stimulation of baroreceptors in the aortic arch and carotid sinus triggers increased sympathetic activity.</p> Signup and view all the answers

What role does myocardial hypertrophy play in cardiac compensation?

<p>Myocardial hypertrophy increases the heart's muscular mass, enhancing its ability to pump blood effectively.</p> Signup and view all the answers

How does cardiac tonogenic dilation contribute to cardiac function?

<p>Cardiac tonogenic dilation adjusts the filling pressures and enhances the heart's ability to contract more effectively.</p> Signup and view all the answers

What is the relationship between stroke volume and heart rate in determining cardiac output?

<p>Cardiac output equals stroke volume multiplied by heart rate.</p> Signup and view all the answers

Why is there a limit to the compensatory increase in heart rate during cardiac insufficiency?

<p>Compensatory increases in heart rate are limited to prevent excessive strain on the heart, especially above &gt;180 beats per minute.</p> Signup and view all the answers

What is the primary role of creatine phosphate (CP) in myocardial energy metabolism?

<p>CP is the main form of energy storage in the myocardium.</p> Signup and view all the answers

How does impaired pyruvic acid metabolism affect myocardial energy production?

<p>Impaired pyruvic acid metabolism leads to reduced myocardial energy production.</p> Signup and view all the answers

Explain how prolonged pressure or volume overload can affect myosin-ATPase activity.

<p>Prolonged overload conditions impair myosin-ATPase activity, reducing energy available for myocardial contraction.</p> Signup and view all the answers

What role does extracellular Ca2+ play in excitation-contraction coupling?

<p>Extracellular Ca2+ influx is crucial for triggering the contraction of myocardial cells.</p> Signup and view all the answers

How does acidosis influence the influx of extracellular Ca2+?

<p>Acidosis slows the depolarization rate, making it difficult for voltage-operated Ca2+ channels to open.</p> Signup and view all the answers

Describe how hyperkalemia affects the sensitivity of β-adrenergic receptors to norepinephrine.

<p>Hyperkalemia depresses the sensitivity of β-adrenergic receptors, making it challenging for norepinephrine to exert its effects.</p> Signup and view all the answers

What happens to the sarcoplasmic reticulum (SR) during disordered calcium handling?

<p>Disordered calcium handling leads to reduced SR uptake and release of Ca2+.</p> Signup and view all the answers

Why is the binding of calcium to troponin essential for muscle contraction?

<p>Calcium binding to troponin is necessary to initiate the excitation-contraction coupling process for muscle contraction.</p> Signup and view all the answers

Flashcards

Low-output heart failure

A type of heart failure where the heart's ability to pump blood effectively is reduced, leading to a decrease in cardiac output.

Acute heart failure

A type of heart failure characterized by a rapid onset and a sharp decrease in cardiac output within a short timeframe.

Chronic heart failure

A type of heart failure characterized by chronic onset, often accompanied by compensatory mechanisms like increased blood volume and heart muscle remodeling.

Left heart failure

A type of heart failure where the left ventricle is unable to pump blood effectively, leading to a buildup of pressure in the lungs.

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Right heart failure

A type of heart failure where the right ventricle is unable to pump blood effectively, leading to a buildup of pressure in the body's tissues.

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High-output heart failure

A type of heart failure characterized by a decrease in cardiac output that occurs during hyperdynamic circulatory states, where the body's demand for blood flow is excessively high.

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Systolic heart failure

A type of heart failure where the heart muscle is unable to contract properly, reducing its ability to effectively pump blood.

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Diastolic heart failure

A type of heart failure where the heart muscle is stiff and has trouble relaxing, making it difficult for the heart chambers to fill with blood.

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Myocardial destruction

Damage to the heart muscle (myocardium) can lead to heart failure.

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Impaired myocardial energy metabolism

Reduction of heart muscle contractility due to inadequate energy supply.

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Dysfunction of excitation-contraction coupling

Disruption of the communication between electrical impulses and muscle contraction in heart muscle.

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Myocardial infarction

Cell death due to inadequate oxygen supply. A common cause of heart failure.

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Apoptosis

A type of cell death that occurs when cells are under stress. This is also found in heart failure.

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Cardiac compensation

The heart's ability to increase its output to meet the body's needs. This is achieved through mechanisms like faster heart rate, stronger contractions, and increased volume of blood pumped per beat.

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Increased heart rate

The heart beats faster to pump more blood per minute.

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Positive inotropic actions of catecholamine

Hormones like adrenaline and noradrenaline (catecholamines) increase the force of heart contractions, boosting the amount of blood pumped with each beat.

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Cardiac tonogenic dilation

The heart chambers stretch and enlarge to accommodate more blood volume, allowing for greater pumping capacity.

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Myocardial hypertrophy

The muscle fibers of the heart thicken and grow in size, leading to stronger contractions and increased blood pumping efficiency.

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Cardiac output

The amount of blood pumped by the heart per minute. It is calculated as stroke volume (amount of blood pumped per beat) multiplied by heart rate (beats per minute).

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Baroreceptors

Specialized receptors located in the aorta and carotid arteries that detect changes in blood pressure. They play a key role in regulating heart rate and blood pressure.

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Sympathetic nervous system

The nervous system responsible for activating the 'fight-or-flight' response, which includes increasing heart rate and blood pressure.

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Concentric hypertrophy

Increased thickness of the heart muscle due to increased workload (pressure overload). This leads to a thicker ventricle wall but a smaller chamber volume.

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Eccentric hypertrophy

Increased length of the heart muscle cells due to increased volume overload. This leads to thinner ventricle walls but a larger chamber volume.

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Increased blood volume

The body's response to heart failure by retaining water and sodium, increasing blood volume.

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Redistributed blood flow

The sympathetic nervous system directs more blood flow to vital organs (brain, heart) while decreasing flow to less essential organs (skin, muscles).

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Erythrocytosis

The body produces more red blood cells (RBCs) in response to low oxygen levels, increasing the blood's oxygen carrying capacity.

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Increased tissue capability to utilize oxygen

Cells adapt to low oxygen levels by improving their ability to utilize oxygen more efficiently.

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Extracardiac compensation

The body's response to heart failure by increasing the workload on the heart, leading to further hypertrophy.

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Neurohumoral mechanisms

Neurohumoral mechanisms, like the sympathetic nervous system and hormones such as aldosterone, contribute to the body's response to heart failure.

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Impairment of myocardial energy metabolism

Refers to conditions that affect the heart's ability to produce, store, or utilize energy, which is essential for proper heart function.

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Creatine Phosphate (CP)?

A critical molecule that stores energy in the heart and provides it for contraction. Low levels indicate deficient energy storage in the myocardium.

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What is Creatine Phosphate Kinase (CK)?

The enzyme responsible for creating and utilizing energy stored in the form of creatine phosphate, important for heart muscle function.

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What is Excitation-Contraction Coupling?

Refers to the process where electrical signals in the heart trigger muscle contractions. It involves the movement of calcium ions into the heart muscle cells.

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What is a Voltage-Operated Calcium Channel (VOC)?

A type of channel in the heart muscle cells, where calcium ions enter to initiate muscle contraction; Plays a crucial role in excitation-contraction coupling, but can be impaired in certain heart conditions.

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What is Sarcoplasmic Reticulum (SR)?

This refers to the storage site for calcium ions in heart muscle cells. It plays a vital role in the calcium cycle, essential for proper heart function.

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What is Troponin?

A crucial protein in muscle cells that binds calcium ions and activates the contraction process.

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What is Myosin?

The main protein in muscle responsible for moving the muscle fibers and generating force during contraction.

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Diastolic dysfunction

A condition where the heart's ability to relax and fill with blood is impaired, leading to reduced cardiac output.

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Ventricular compliance

The ratio of ventricular volume change to the corresponding change in intraventricular pressure.

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Asynergic of contraction and relaxation

Implies a heart muscle that is not contracting and relaxing in a coordinated manner. The heart's chambers may not be pumping blood efficiently.

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Low output syndrome

A complex condition where the heart's ability to pump blood effectively is diminished due to a variety of factors such as reduced muscle function, valve problems, or electrical abnormalities.

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Venous congestion syndrome

A situation where the heart cannot efficiently pump blood, leading to a backup of blood in the venous system. This results in symptoms like swelling in the legs and abdomen.

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