ABSTRACT Background: Heart failure with preserved ejection fraction (HFpEF) is characterized by diastolic dysfunction, as well as alterations in ventricular filling and remodelling. This change in diastolic function without reduced ejection fraction is manifested as exercise intolerance, and arterial stiffness, measured by pulse pressure, is considered an independent predictor of functional capacity. Objective: To evaluate the correlation between sub-maximal functional capacity and pulse pressure (PP) in patients with HFpEF. Methods: Patients with HFpEF performed the 6-minute walk test (6MWT) in […]

Introduction Heart failure (HF) is a progressive disease marked by a pattern of gradual decline interspersed with episodes of acute deterioration. This often culminates in either sudden death or hospitalization.– Discussing its trajectory, especially in emergency decompensations, can be challenging when physicians predict these situations using palliative care (PC) principles and practices., The World Health Organization defines PC as a patient and family-centered approach aimed to enhance the overall quality of life (QoL) by proactively addressing, preventing, and alleviating suffering. […]

Introduction Heart failure (HF) can be a serious disease if not treated properly. One of the markers of severity is precisely hospitalization due to HF, often called acute HF or acutely decompensated (ADHF). ADHF involves patients with new HF or an exacerbation of chronic HF. The most common symptoms and signs in ADHF are dyspnea and edema of the lower limbs. Dyspnea, when it occurs in isolation, with no specific signs of HF, can hinder the diagnosis. In this context, […]

There has been remarkable progress in the treatment of heart failure (HF) over the past years. Medications such as angiotensin receptor-neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors (SGLT2i), often referred to as the “fantastic four,” have been shown to reduce mortality and hospitalization, in addition to improving patients’ quality of life. The natural history of the disease is characterized by recurrent episodes of decompensation and hospital admission linked to pulmonary and/or systemic congestion. Although diuretics […]

Over the last 35 years, cardiology, especially the field of heart failure (HF), has witnessed a true therapeutic revolution based on scientific evidence. First, with vasodilators, moving on to the neurohumoral pathophysiological hypothesis with ACE inhibitors (ACEI), beta-blockers, mineralocorticoid antagonists, and, more recently, neprilysin inhibitors and SGLT2 inhibitors, caused a reduction in morbimortality rarely seen in the history of medicine. However, virtually all evidence associated with this impressive reduction in events comes at the expense of benefits in patients with […]

Persistent congestion despite the use of loop diuretics (LD) is one of the most important challenges in the management of acute heart failure (HF) and is associated with a worse prognosis. One of the main reasons for this persistence in congestion is resistance to LD, which can be defined as a reduction in sensitivity to diuretics, with reduced natriuresis and diuresis and limitation of reaching euvolemia – LD can reach up to 1/3 of patients admitted for acute HF and […]

Introduction Heart failure (HF) is a complex clinical syndrome that promotes a system of poor tissue perfusion in conditions of low cardiac output and elevated filling pressures, resulting in circulatory congestion and hypoperfusion. The exacerbation of this condition is responsible for 40% of consultations due to dyspnea in emergency rooms, and the main cause is worsening congestion due to poor medication adherence. In in-hospital clinical assessment, the most prevalent HF profiles are B (warm and wet) and C (cold and […]

Abstract The administration of hypertonic saline (HS) in decompensated heart failure (HF) seems counterintuitive, given the concept that sodium is universally harmful for these patients. However, increasingly, strict sodium restrictions have been questioned due to the lack of proven benefits. On the other hand, we know that in acute HF complicated with diuretic resistance, there is hyperactivation of the renin-angiotensin-aldosterone system (RAAS), resulting in a state of excessive increase in renal avidity for sodium, hindering the action of loop diuretics. […]

Pathophysiology Over the last few decades, much has been discovered about the pathophysiological processes of chronic HF, especially myocardial remodeling, signaling important pharmacological targets that have proven to impact clinical outcomes. In the scenario of post-infarction HF, some peculiarities in these processes have been better understood, helping to understand specific characteristics of this clinical phenotype of HF and enabling a more targeted approach in this scenario. Initially, ischemia leads to loss of contractile function and consequently enlarges the ventricular cavity, […]

Introduction In the scenario of cardiogenic shock, attention was almost exclusively focused on the left ventricle (LV). Currently the concept that the circulatory system involves the interdependence between the LV and the right ventricle (RV) has been reinforced, and researchers seek to achieve a clearer understanding of the role of the right ventricle in cardiogenic shock. In the 1940s, in search of a more in-depth understanding of the role of the RV, the American doctor and researcher Isaac Starr and […]

Abstract Nearly 80% of all patients hospitalized for decompensated heart failure (HF) present hypervolemia with signs and symptoms of congestion,, for which decongestion is an essential pillar of treatment. Most guidelines recommend the use of loop diuretics as soon as the patient is admitted.– Despite this, a post-hoc analysis of the DOSE-AHF and CARRESS-HF studies showed that only half of these patients were free of congestion at the moment of high discharge, this being the group with the highest mortality […]

Introduction Heart failure (HF) syndrome was first described as an emerging epidemic almost 30 years ago. Due to population growth and aging, the total number of patients with HF has increased over the past years. Acute decompensated HF (ADHF) is estimated to be the leading cause of hospitalization, based on data available from 50% of the South American population. The standard treatment for patients with ADHF includes diuretics, vasodilators, and sodium restriction. […]

Introduction Acute heart failure (AHF), which is the syndrome where there is a rapid or gradual worsening of chronic or new heart failure (HF), is one of the main causes of emergency department visits, and it is the leading cause responsible for non-elective hospitalizations in patients over 65 years of age, with an elevated readmission rate at 1 year. In-hospital mortality due to AHF is 3% to 4% in international registries, reaching 12.6% in the Brazilian BREATHE registry. When we […]

Abstract High-output heart failure (HOHF) is a less common form of heart failure and presents as the inability of the heart to supply enough blood for the body’s needs. HOHF can be divided into two categories: 1. increased demand for increased metabolism or 2. arteriovenous shunts increasing venous circulation flow and decreasing resistance, leading to increased oxygen consumption and low systemic vascular resistance. The most common causes are obesity, liver disease, shunts, lung disease, myeloproliferative diseases, hyperthyroidism, and thiamine deficiency.

Abstract Heart failure (HF) is a progressive condition, characterized by variable periods of symptomatic stability frequently interrupted by episodes of A worsening condition. These moments of clinical deterioration have been recognized as a distinct phase in the course of HF and indicate a considerably worse prognosis. Preventing readmissions of patients with HF is a growing priority for medical providers, researchers, and healthcare managers. Although evidence-based therapies for treating patients with HF have increased, consistent implementation of these therapies and the […]

Introduction Shock is defined as a state of tissue hypoperfusion due to reduced supply, increased consumption, inadequate use of oxygen, or a combination of these processes. When it is of cardiogenic etiology, it occurs as a result of left or right ventricular or biventricular dysfunction with reduced cardiac output (CO) or increased filling pressures and normal intravascular volume. Although the most classic manifestation of shock is arterial hypotension, it is essential to recognize that a patient in shock may present […]

Cardiogenic shock (CS) is defined by the presence of signs and symptoms of low tissue perfusion associated with systolic blood pressure (BP) < 90mmHg, according to the European Society of Cardiology. Within the different types of shock – cardiogenic, distributive, hypovolemic, and mixed – CS is responsible for up to 66% of shock cases in intensive care units and occurs due to poor perfusion secondary to low cardiac output. The most prevalent etiology is ST-elevation myocardial infarction (STEMI); other causes […]

ABC Heart Fail Cardiomyop. 2023; 3(1):e20230040 ABC Heart Fail Cardiomyop. 2023; 3(1):e20230040 In the Review Article “Diagnosis and Treatment of Hypertrophic Cardiomyopathy”, with https://doi.org/10.36660/abchf.20230040, published in the journal ABC Heart Failure & Cardiomyopathy, ABC Heart Fail Cardiomyop. 2023; 3(1):e20230040, on page 1, correct the author’s name: Mariani Mendes Madison for: Mariani Mendes Madisson Bernardo. […]