What is the heart failure phenotype and why is this important?

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Presentation transcript:

What is the heart failure phenotype and why is this important? James Dollard Consultant Cardiologist General physician

What is heart failure? Symptoms Signs Abnormal cardiac function as assessed by ECHO Can be systolic Diastolic Both Raised BNP

Left ventricular contraction (systole) During LV systole the LV wall: shortens Thickens Twists INOTROPY

Left ventricular Relaxation (diastole) The LV has to relax and expand RAPIDLY (essentially as quickly as it contracts) LUSITROPY Passive and active ATP is used to hoover up calcium back into the SR Nagueh et al, EHJ Card Imag 2016

Why is an ECHO essential?

Echo reports What can I ignore? What’s Important? Anything that’s mild! Mild MR or TR PFO Aortic Sclerosis Most things on an ECHO are reported for future reference by the cardiologist and are not relevant! LV function Ejection Fraction LVIDd (the diameter of the heart when it’s full) LV wall thickness Filling pressures LA volume Dilated IVC Assessment of diastolic function Anything severe!

What is the Ejection Fraction and why is it important?