1
Cardiovascular Disorders: Part I
- Categories of heart failure: HFrEF vs HFpEF
- Calculating the ejection fraction
HFrEF (heart failure with reduced ejection fraction) HFpEF (heart failure with preserved ejection fraction)
EF < 40% (systolic dysfunction) EF > 50% (diastolic dysfunction)
Typically pts w/ ischemic heart disease Typically pts with HTN
Both systolic and diastolic heart failure can have the following manifestations:
Left ventricular HF Right ventricular HF
Pulmonary congestion (back pressure) > Increase hydrostatic Right ventricular heart failure > systemic venous congestion >
pressure in the pulmonary will increase water diffusing into the alveoli distended neck veins and tender congested liver > portal
> dyspnea > orthopnea (patient will breathe better when standing up hypertension > ascites + splenomegaly + lower limb edema
but SOB when lying supine) > paroxysmal nocturnal dyspnea (attacks
of dyspnea overnight) > wet/exertional cough (water irritates bronchi)
> pulmonary edema (water fills the lungs/bronchi = pink frothy
sputum!)
Clinical manifestations of HFrEF and HFpEF are the same
Echocardiography is the test to differentiate
Calculating the Ejection Fraction (EF)
CO = SV (Stroke volume) x HR (Heart rate)
EF = SV/EDV (End diastolic volume)
SV = ED (End diastolic) - ES (End systolic)
- Remodeling in heart failure: causes and molecular mechanisms
This study source was downloaded by 100000898960505 from CourseHero.com on 05-15-2025 19:45:14 GMT -05:00
https://www.coursehero.com/file/239882331/Understanding-Heart-Failure-Ejection-Fraction-Compensatory/
, 2
- Compensatory mechanisms in heart failure: effects on preload and afterload
1. Frank-Starling Mechanism
2. Sympathetic nervous system activity
3. Renin-Angiotensin-Aldosterone system (RAAS)
4. Natriuretic peptides (ANP, BNP)
a. Produced by the heart muscle and have potent diuretic and natriuretic actions
5. Endothelins
a. Potent vasoconstrictors released from the vascular endothelium
6. Myocardial hypertrophy and remodeling
a. Eventually leading to structural and functional changes that often lead to further pump dysfunction
This study source was downloaded by 100000898960505 from CourseHero.com on 05-15-2025 19:45:14 GMT -05:00
https://www.coursehero.com/file/239882331/Understanding-Heart-Failure-Ejection-Fraction-Compensatory/
Cardiovascular Disorders: Part I
- Categories of heart failure: HFrEF vs HFpEF
- Calculating the ejection fraction
HFrEF (heart failure with reduced ejection fraction) HFpEF (heart failure with preserved ejection fraction)
EF < 40% (systolic dysfunction) EF > 50% (diastolic dysfunction)
Typically pts w/ ischemic heart disease Typically pts with HTN
Both systolic and diastolic heart failure can have the following manifestations:
Left ventricular HF Right ventricular HF
Pulmonary congestion (back pressure) > Increase hydrostatic Right ventricular heart failure > systemic venous congestion >
pressure in the pulmonary will increase water diffusing into the alveoli distended neck veins and tender congested liver > portal
> dyspnea > orthopnea (patient will breathe better when standing up hypertension > ascites + splenomegaly + lower limb edema
but SOB when lying supine) > paroxysmal nocturnal dyspnea (attacks
of dyspnea overnight) > wet/exertional cough (water irritates bronchi)
> pulmonary edema (water fills the lungs/bronchi = pink frothy
sputum!)
Clinical manifestations of HFrEF and HFpEF are the same
Echocardiography is the test to differentiate
Calculating the Ejection Fraction (EF)
CO = SV (Stroke volume) x HR (Heart rate)
EF = SV/EDV (End diastolic volume)
SV = ED (End diastolic) - ES (End systolic)
- Remodeling in heart failure: causes and molecular mechanisms
This study source was downloaded by 100000898960505 from CourseHero.com on 05-15-2025 19:45:14 GMT -05:00
https://www.coursehero.com/file/239882331/Understanding-Heart-Failure-Ejection-Fraction-Compensatory/
, 2
- Compensatory mechanisms in heart failure: effects on preload and afterload
1. Frank-Starling Mechanism
2. Sympathetic nervous system activity
3. Renin-Angiotensin-Aldosterone system (RAAS)
4. Natriuretic peptides (ANP, BNP)
a. Produced by the heart muscle and have potent diuretic and natriuretic actions
5. Endothelins
a. Potent vasoconstrictors released from the vascular endothelium
6. Myocardial hypertrophy and remodeling
a. Eventually leading to structural and functional changes that often lead to further pump dysfunction
This study source was downloaded by 100000898960505 from CourseHero.com on 05-15-2025 19:45:14 GMT -05:00
https://www.coursehero.com/file/239882331/Understanding-Heart-Failure-Ejection-Fraction-Compensatory/
