![]() ![]() ![]() In contrast, patients with infiltrative cardiomyopathies such as cardiac amyloidosis, sarcoidosis and haemochromatosis may initially present with HFpEF, although the cause is clearly different from patients with hypertrophy caused by systemic hypertension. Simplified explanation of heart failure with preserved ejection fraction using the balloon and football analogy Severe aortic stenosis produces LVH in a similar fashion to longstanding severe systemic hypertension.įigure 2. In some patients with HFpEF, a smaller left ventricular cavity resulting from concentric hypertrophy can cause a decrease in stroke volume despite a deceptively normal ejection fraction. This in turn causes myocardial ischaemia, which occurs due to the degree of hypertrophy outstripping the myocardial blood supply, resulting in fibrosis and stiffness of the left ventricle. A classic example of this is left ventricular hypertrophy (LVH) caused by longstanding hypertension, in which chronic systemic pressure overload causes increased left ventricular muscle mass. The most common cause of HFpEF is left ventricular diastolic dysfunction secondary to a stiff, hypertrophied left ventricle causing elevated left ventricular filling pressure (Figure 2). HFpEF, heart failure with preserved ejection fraction Heart failure with preserved ejection fraction and its risk factors (comorbid conditions), which are interlinked A diagnosis relies on thorough interpretation of the entire echocardiogram, including left ventricular mass, left atrial volume and assessment of diastolic function. Unlike impaired ejection fraction, which reliably defines heart failure with reduced ejection fraction (HFrEF), the diagnosis of HFpEF can be challenging as there is no single abnormal echocardiographic parameter that defines its presence. ![]() It can potentially become a major burden to healthcare systems worldwide, which are already overstretched. HFpEF is a rapidly growing problem due to an ageing population as well as increased incidence of risk factors such as hypertension, diabetes and obesity (Figure 1). 1 HFpEF is not a single condition but a result of many different pathologies, adding challenges to management. Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome in which patients have clinical features of heart failure in the presence of normal or near-normal left ventricular ejection fraction, usually defined as ejection fraction at 50% or above. ![]()
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