Pathophysiology of Heart Failure

Contraindication, a condition that makes a particular treatment or procedure inadvisable or dangerous.

Estimated creatinine clearance, a measure of kidney function.

Cardiac resynchronization therapy device, a type of implanted device to help improve the heart's pumping.

Guideline-directed medical therapy, a treatment plan following established clinical guidelines.

Implantable cardioverter-defibrillator, a device that delivers electric shocks to correct irregular heartbeats.

Left bundle branch block, a heart condition affecting the electrical pathways.

Left ventricular assist device, a mechanical pump that supports the heart's pumping function.

Myocardial infarction, commonly known as a heart attack.

Heart failure with reduced ejection fraction, a type of heart condition.

Heart failure severity, from mild (II) to severe (IV).

Kidney function level—good enough for certain heart failure treatments.

Potassium levels—important for heart function.

Cardiac resynchronization therapy—resynchronizes heart pumping.

Medication to lower heart rate for heart failure.

A loop diuretic used for patients with sulfa allergy. It's similar to furosemide but can cause ototoxicity at high doses.

Diuretics like hydrochlorothiazide and chlorthalidone. They have limited use in heart failure due to low maximal effect and loss of efficacy at low GFR.

Diuretics like metolazone, work better than thiazides at low GFR and are more effective than thiazides but less potent than loop diuretics.

Combining thiazides and loop diuretics to treat heart failure. This is often used when patients are unresponsive to loop diuretics alone.

Can cause ototoxicity, a side effect that affects the ears and hearing.

Heart failure with preserved ejection fraction, a type of heart failure where the heart muscle can't relax properly, leading to poor filling and reduced blood flow.

Heart failure with reduced ejection fraction, a type of heart failure where the heart muscle can't pump blood efficiently, leading to reduced blood flow.

The percentage of blood that is pumped out of the left ventricle with each heartbeat. A normal EF is typically above 50%.

The ability of the heart muscle to relax and fill with blood between beats.

The ability of the heart muscle to contract and pump blood out to the body.

An enzyme that produces nitric oxide, a molecule involved in various physiological processes including blood vessel dilation.

A chemical process where nitric oxide attaches to a molecule, potentially altering its function.

A state where the endoplasmic reticulum, a cellular organelle, is unable to function properly, leading to cell dysfunction.

A type of physical activity designed to improve cardiovascular fitness and overall health.

The maximum amount of oxygen a person can consume during exercise, representing their aerobic capacity.

HFpEF is more common in women compared to men and its prevalence increases with age, indicating a higher chance of occurrence as people get older.

HFpEF involves a stiff left ventricle that struggles to relax and fill with blood, leading to congestion in the lungs, shortness of breath, and potential pulmonary edema.

Commonly, HFpEF is linked to high blood pressure, ischemic heart disease, diabetes, and obesity.

HFpEF involves increased fibrosis in the heart, causing permanent relaxation problems, and altered titin phosphorylation, affecting the muscle's ability to stretch.

HFpEF often worsens with high blood pressure, leading to a sudden decline in heart function.

A system to categorize heart failure severity based on symptoms: Class I - no symptoms, Class II - symptoms during moderate activity, Class III - symptoms with minimal activity, Class IV - symptoms at rest.

The AHA/ACC guidelines expand on the NYHA classification by adding a stage A, which represents the pre-heart failure phase with modifiable risk factors.

Stage A in the AHA/ACC guidelines focuses on identifying and managing risk factors that can lead to the development of heart failure, allowing for early intervention.