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10  Chapter General Discussion
10 Chapter General Discussion

... represent distinct HF phenotypes2,5-7. Elevated diastolic left ventricular (LV) stiffness is an important feature in HFpEF8-10. Numerous studies, of which several are included in the present thesis, demonstrated that raised intrinsic cardiomyocyte stiffness (Fpassive) importantly contributes to high ...
Ventricular Structure and Function
Ventricular Structure and Function

... necessity of a surgical intervention in severe aortic13–20 or mitral21–26 regurgitation. These cutoff values have entered the current guidelines27,28 for the management of valvular heart disease. It was consistently shown that besides symptomatic status and ventricular systolic function, LV dimensio ...
Xiphoid horn in pectus excavatum
Xiphoid horn in pectus excavatum

... visible on preoperative radiographs. Eight per cent of pectus excavatum patients have organic heart disease (Reusch, 1961). Funnel chest may cause anginoid pain (Poppe, 1965) which can be relieved surgically. A previously unreported abnormality is here recorded. In pectus excavatum there may be a ca ...
Tracking the Right Ventricle - JACC: Cardiovascular Imaging
Tracking the Right Ventricle - JACC: Cardiovascular Imaging

... high reproducibility of parameters in this study are encouraging and may help in the increased use of such parameters in routine clinical practice with confidence. A parameter such as isovolumic acceleration is a validated, load-independent measure of contractility, but varies with heart rate (5). W ...
Left Stellate Ganglion and Vagal Nerve Activity and Cardiac
Left Stellate Ganglion and Vagal Nerve Activity and Cardiac

... of baseline noise and then identified as ANS activity all signals that were 3 times higher than the baseline noise. The ANS activity was high-pass (125 Hz) filtered, rectified, and summed over fixed time segments to represent the total nerve activity. These analyses were done for each dog at 1 basel ...
12 Lead ECG Interpretation - Learning
12 Lead ECG Interpretation - Learning

... • It is the hallmark of Myocardial Infarction • The injured myocardium is slow to repolarise and remains more positively charged than the surrounding areas • Other causes to be ruled out include pericarditis and ventricular aneurysm ...
Resting heart rate as a tool for risk stratification in primary
Resting heart rate as a tool for risk stratification in primary

... epidemiological analyses15,16 and clinical trials,6,17 the data available for resting heart rate as a cardiovascular risk factor in subjects free of coronary artery disease is inconclusive. In one of the largest analysis so far in nearly 380,000 subjects, all within one age-group of 40–45 years, the ...
12 Lead ECG Interpretation
12 Lead ECG Interpretation

... • It is the hallmark of Myocardial Infarction • The injured myocardium is slow to repolarise and remains more positively charged than the surrounding areas • Other causes to be ruled out include pericarditis and ventricular aneurysm ...
PDF
PDF

... As previously mentioned, these growths may produce sudden death (9 of 27 cases) without giving rise to previous symptoms. Although the tumors are histologically benign, they are liable, by virtue of then- location, to interfere with the conduction system and, therefore, to cause death. They may, how ...
Review Article Heart failure with preserved ejection fraction
Review Article Heart failure with preserved ejection fraction

... Clinical signs and symptoms are similar to systolic heart failure. Interestingly, symptoms of dyspnoea correlate better with HFPEF than with reduced ejection fraction (HFREF), and people with reduced EF may even have better exercise capacity than patients with normal EF and diastolic dysfunction [2- ...
Gene Electro Transfer of Plasmid Encoding Vascular Endothelial
Gene Electro Transfer of Plasmid Encoding Vascular Endothelial

... skeletal muscle [6] and to cardiac tissue [7, 8]. Previously, we and others demonstrated that electro transfer could be used effectively to deliver plasmid DNA directly to cardiac tissue in vivo [7–10]. We have further confirmed that electro transfer is a viable approach for delivering plasmid DNA i ...
Vegfa Impacts Early Myocardium Development in Zebrafish
Vegfa Impacts Early Myocardium Development in Zebrafish

... in proximity to the prospective heart fields at 18-somite stage (Figure 1J,K), in agreement with the previous reports [14]. Expression of vegfaa in the heart field was downregulated after early migration. vegfab expression was not detected during early embryonic development (Figure S1C,D). We also u ...
PAJ-6370-Clinical-Brief
PAJ-6370-Clinical-Brief

... It is widely accepted that regular aerobic exercise reduces cardiovascular risk (Li et al., 2010). Many health care providers harp on the importance of exercise and diet, but many patients hear this without listening. While exercise seems to be avoided at all costs by much of the population, other p ...
Syncope - A Clinical Point of View - The Association of Physicians of
Syncope - A Clinical Point of View - The Association of Physicians of

... may be the only warning sign before sudden cardiac death (2). - In up to 50% cases etiology may not be evident inspite of detailed evaluation (1). - In many cases, etiology may be multifactorial in the same episode or may be different in different episodes. - Patient may have seizure at one time ...
Understanding Lusitropy
Understanding Lusitropy

... myocardium plays role in limiting coronary perfusion (7). ...
School of Health Sciences - University of Nottingham
School of Health Sciences - University of Nottingham

... In the introduction, it was pointed out that, in sinus rhythm, the P-R interval should be 3-5 small squares. (Some books will say up to 5½ small squares) This measurement represents the time it takes for the atria to depolarise (P wave), and the delay of the stimulus in the AV node (the flat line fo ...
Standardized Definitions for End Point Events
Standardized Definitions for End Point Events

... cardiac death, death due to heart failure, death due to stroke, and death due to other cardiovascular causes, as follows: 1. Death due to Acute Myocardial Infarction refers to a death by any mechanism (arrhythmia, heart failure, low output) within 30 days after a myocardial infarction (MI) related t ...
HRS-004 PULSE layout_hrs.indd
HRS-004 PULSE layout_hrs.indd

... first step toward the creation of an AF Ablation Registry. • The Society participated in the development of quality measures related to heart rhythm disorders such as the ICD complication and heart failure measures. • The ICD Longitudinal Study launched in the early fall of 2009. This observational ...
Braunwald`s Heart Disease Review and Assessment
Braunwald`s Heart Disease Review and Assessment

... A. This test is conclusive for severe stenosis of the proximal right coronary artery B. His risk of death due to an acute myocardial infarction during the next year is >50% C. He should proceed directly to coronary angiography D. The test predicts a 25% risk of cardiac events over the next 5 yea ...
Left Ventricular Assist Devices
Left Ventricular Assist Devices

...  Better durability (simpler mechanics) and quieter  Increased blood flow (10 L/min) reduced blood stasis and hemolysis ...
Clinicopathologic characteristics of elderly patients with
Clinicopathologic characteristics of elderly patients with

... admission, Patient 6 showed positive C-reactive protein and mild pericardial effusion on the echocardiogram, but this disappeared a few weeks later. Virologic tests performed in one patient failed to show a fourfold increase in antibody titer in serum samples obtained during the acute and convalesce ...
Deteriorating Patients With Chronic
Deteriorating Patients With Chronic

... excluded 13 patients with overt cardiac disease who met at least one of the following criteria: positive exercise test for ischemia by ECG, intercurrent ischemic events (intercurrent myocardial in¬ farction or unstable angina), or concurrent coronary revascular¬ ization; and two patients for the abs ...
The decrease of cardiac chamber volumes and output during
The decrease of cardiac chamber volumes and output during

... cardiac magnetic resonance imaging (CMR) that with steadystate, free-precession sequences is considered the gold standard of in vivo measurements of cardiac chamber volumes (10, 11, 21). CMR is particularly useful in evaluation of the right side of the heart, which cannot be reliably measured with e ...
Autonomic Consequences of Cerebral Hemisphere Infarction
Autonomic Consequences of Cerebral Hemisphere Infarction

... after stroke on the right (P=2.9xlO~5)Conclusions Power spectral analysis of heart rate variability can detect autonomic consequences of stroke. The spectral data predict that, to the degree that cardiac arrhythmia is produced by unbalanced cardiac autonomic activity favoring the sympathetic system, ...
cardiovascular disturbances caused by deficiency of vitamin b1
cardiovascular disturbances caused by deficiency of vitamin b1

... visible in the retinal arteries. The blood pressure was 135/80 mm. The pulse was regular and the rate 120. The apex beat was felt three quarters of an inch external to the left nipple line. The heart sounds were tic-tac in quality, and no murmurs were heard. The respirations were 23 per minute, and ...
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Heart failure



Heart failure (HF), often referred to as congestive heart failure (CHF), occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the body's needs. The terms chronic heart failure (CHF) or congestive cardiac failure (CCF) are often used interchangeably with congestive heart failure. Signs and symptoms commonly include shortness of breath, excessive tiredness, and leg swelling. The shortness of breath is usually worse with exercise, while lying down, and may wake the person at night. A limited ability to exercise is also a common feature.Common causes of heart failure include coronary artery disease including a previous myocardial infarction (heart attack), high blood pressure, atrial fibrillation, valvular heart disease, excess alcohol use, infection, and cardiomyopathy of an unknown cause. These cause heart failure by changing either the structure or the functioning of the heart. There are two main types of heart failure: heart failure due to left ventricular dysfunction and heart failure with normal ejection fraction depending on if the ability of the left ventricle to contract is affected, or the heart's ability to relax. The severity of disease is usually graded by the degree of problems with exercise. Heart failure is not the same as myocardial infarction (in which part of the heart muscle dies) or cardiac arrest (in which blood flow stops altogether). Other diseases that may have symptoms similar to heart failure include obesity, kidney failure, liver problems, anemia and thyroid disease.The condition is diagnosed based on the history of the symptoms and a physical examination with confirmation by echocardiography. Blood tests, electrocardiography, and chest radiography may be useful to determine the underlying cause. Treatment depends on the severity and cause of the disease. In people with chronic stable mild heart failure, treatment commonly consists of lifestyle modifications such as stopping smoking, physical exercise, and dietary changes, as well as medications. In those with heart failure due to left ventricular dysfunction, angiotensin converting enzyme inhibitors or angiotensin receptor blockers along with beta blockers are recommended. For those with severe disease, aldosterone antagonists, or hydralazine plus a nitrate may be used. Diuretics are useful for preventing fluid retention. Sometimes, depending on the cause, an implanted device such as a pacemaker or an implantable cardiac defibrillator may be recommended. In some moderate or severe cases cardiac resynchronization therapy (CRT) may be suggested or cardiac contractility modulation may be of benefit. A ventricular assist device or occasionally a heart transplant may be recommended in those with severe disease despite all other measures.Heart failure is a common, costly, and potentially fatal condition. In developed countries, around 2% of adults have heart failure and in those over the age of 65, this increases to 6–10%. In the year after diagnosis the risk of death is about 35% after which it decreases to below 10% each year. This is similar to the risks with a number of types of cancer. In the United Kingdom the disease is the reason for 5% of emergency hospital admissions. Heart failure has been known since ancient times with the Ebers papyrus commenting on it around 1550 BCE.
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