Blausen Medical
Blausen Medical

Blausen Medical

Medically accurate and informative 3D animations



"Heart failure is the inability of the heart to provide adequate blood to the body and its organs at rest or during exercise, or at the expense of elevated filling pressure. Heart failure with preserved ejection fraction or “heff-peff” is characterized by stiff ventricles with a preserved ejection fraction. This is usually caused by an impairment in diastolic function which is characterized by impaired relaxation of the left ventricle, and reduced left ventricular compliance, resulting in increased left ventricular diastolic pressures. The ventricle is too stiff to allow normal filling during diastole, and so pressures are high to get blood into the ventricle. Left atrial enlargement is also often seen in HFpEF. Several factors contribute to the pathophysiology of this multi-factorial disease. Hypertension is an example of a common cause of HFpEF and drives arterial stiffness, as well as ventricular hypertrophy and fibrosis. Elevated blood pressure and stiff arteries result in increased peripheral resistance in the circulation and the heart must work harder to pump blood through these stiff vessels. This increased strain on the heart may result in hypertrophied ventricles which contribute to the dysfunction we see in HFpEF. Comorbidities like aging, obesity, and metabolic disease may drive myocardial dysfunction and remodeling on a cellular level that contributes to ventricular stiffness. These comorbidities are linked to an increase in microvascular endothelial inflammation and the generation of reactive oxygen species, which ultimately contributes to nitric oxide deficiency. In a normal heart, nitric oxide is available to initiate a pathway that causes muscle relaxation. Without nitric oxide available for this pathway, however, there is less cyclic GMP available to activate Protein Kinase G, a protein involved with muscle relaxation. Relaxation is slower, which results in stiff ventricles. All the causes described previously contribute to diastolic dysfunction and diastolic dysfunction also contributes to those mechanisms."

Duration: 02:41
Licence: CC - Attribution
Original Language: English
Published: 8/9/2019
Diseases and Conditions: Heart Failure
Format: 3D Animation

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