From the Guidelines
Heart failure is a clinical syndrome characterized by symptoms and/or signs caused by a structural and/or functional cardiac abnormality, corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion, as defined by major worldwide scientific bodies in 2021 1.
Definition and Classification
The definition of heart failure (HF) has been refined over time, with the most recent consensus proposing a universal definition and classification of HF based on left ventricular ejection fraction (EF) into three categories: HF with reduced EF (HFrEF), mildly reduced EF (HFmrEF), and preserved EF (HFpEF) 1.
Key Characteristics
HF is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood, leading to symptoms such as dyspnea, fatigue, and fluid retention 1.
Causes and Prevalence
The condition can result from various underlying conditions, including coronary artery disease, high blood pressure, heart valve problems, cardiomyopathy, or congenital heart defects, with a significant global burden, affecting an estimated 64.3 million people worldwide in 2017 1.
Management and Prognosis
HF is a progressive condition that can be managed with medications and lifestyle modifications, but without proper treatment, it can significantly reduce quality of life and lead to serious complications, including kidney damage, liver damage, and potentially life-threatening cardiac arrhythmias 1. Some key points to consider in the management of HF include:
- Classification based on EF to guide treatment strategies
- Use of medications such as ACE inhibitors, beta-blockers, diuretics, and aldosterone antagonists
- Lifestyle modifications, including sodium restriction, regular exercise, and fluid management
- Regular monitoring of symptoms, signs, and laboratory tests to adjust treatment as needed It is essential to prioritize the most recent and highest-quality evidence when making clinical decisions, and in this case, the 2021 consensus definition and classification of HF provide a framework for understanding and managing this complex condition 1.
From the Research
Definition of Heart Failure
- Heart failure (HF) is a complex syndrome characterized by the inability of the heart to maintain a normal cardiac output without elevated intracardiac filling pressures, resulting in signs of pulmonary and peripheral edema and symptoms of dyspnea and fatigue 2.
- HF is a syndrome characterized by the inability of the heart to meet the body's circulatory demands 3.
- It is a heterogeneous clinical syndrome stemming from cardiac overload and injury that leads to considerable morbidity and mortality 4.
- HF is a complex clinical syndrome characterized by different etiologies and a broad spectrum of cardiac structural and functional abnormalities 5.
- It is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return 6.
Key Characteristics
- HF results from injury to the myocardium from a variety of causes, including ischemic heart disease, hypertension, and diabetes 6.
- It is characterized by symptoms such as dyspnea, peripheral edema, and fatigue 2, 6.
- Compensatory mechanisms, including increasing cardiac output and ventricular remodeling, occur as the failing heart attempts to maintain adequate function 6.
- These mechanisms eventually lead to a vicious cycle of worsening heart failure 6.