RT Book, Section
A1 Gaggin, Hanna K.
A1 Dec, G. William
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1161716326
T1 PATHOPHYSIOLOGYOF HEART FAILURE
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accessmedicine.mhmedical.com/content.aspx?aid=1161716326
RD 2024/04/19
AB Heart  failure  (HF)  is  a  complex  clinical  syndrome  associated  with  increased  mortality  and  morbidity.1  It  is  also  common  and  becoming  more  prevalent  with  the  aging  population  and  improvement  in  survival  of  patients  with  cardiovascular  diseases  such  as  coronary  artery  disease.  Although  coronary  artery  disease  is  the  most  common  cause  of  HF,  patients  can  develop  HF  from  any  number  of  different  cardiovascular  diseases  (Table  68–1);  HF  appears  to  be  the  final  common  pathway  of  ventricular  dysfunction  that  share  some  important  clinical  characteristics  and  pathophysiology.  Although  the  molecular  biology  and  integrated  physiology  behind  HF  remain  incompletely  understood,  several  fundamental  concepts  and  principles  have  evolved  and  are  described  here.  In  addition,  many  of  the  same  proteins  found  in  key  HF  pathophysiologic  pathways  have  been  evaluated  as  potential  biomarkers  in  HF  (some  are  well  established  in  their  clinical  utility  for  diagnostic  and  prognostic  purposes)  and  are  important  targets  of  therapeutic  applications  and  exploration.  An  important  caveat  is  that  many  of  the  proven  concepts  in  HF  were  derived  from  HF  models  with  reduced  ejection  fraction  (HFrEF),  and  relatively  little  is  known  about  the  mechanisms  involved  in  the  development  of  HF  with  preserved  ejection  fraction  (HFpEF).  A  special  section  on  the  pathophysiology  of  HFpEF  is  presented  near  the  end  of  this  chapter.  Again,  some  of  the  concepts  are  shared  between  HFrEF  and  HFpEF.