Heart failure with preserved left ventricular ejection fraction

    Authors

    Keywords

    heart failure, education

    DOI

    https://doi.org/10.15836/ccar2018.502

    Full Text

    Heart failure (HF) is a clinical syndrome that occurs as a consequence of cardiac function and structure disorders, resulting in insufficient oxygen supply to the tissue and the inability to satisfy the metabolic needs of the body. The main characteristics of this syndrome are repeated hospitalizations, negative impacts on the quality of the patient’s life, an unfavorable outcome and a large economic burden on the health system. According to the values of the left ventricular ejection fraction (LVEF) heart failure can be divided into HF with reduced LVEF (HFrEF, LVEF <40%), HF with a medium range LVEF (HFmEF, LVEF 40-49%), and HF with preserved LEVF (HFpEF, LVEF >50%). Nearly half of all patients suffering from HFpEF and the incidence of HFpEF increases steadily in developed countries, primarily due to the increase of risk factors, specifically life expectancy, female gender, hypertension, diabetes, kidney failure and obesity. ( 1 ) First symptoms and signs of HFpEF occur during strain, stress or exercise. Atrial fibrillation (AF), as one of the comorbidities, leads to reduced left atrial (LA) filling, while long term untreated AF results in mechanical and electrical cardiac dyssynchrony. Elevated LA pressure leads to pulmonary hypertension which results in increased pressure values in the right ventricle and consequently affects the negative remodeling of the right ventricle and, eventually, right ventricle failure. HFpEF is diagnosed on the basis of the present symptoms and signs of HF as well as the results of echocardiography EF > 50%, increased LA, pulmonary hypertension, electrocardiogram, xhest X-ray and value of NT-proBNP. The treatment of HFpEF is limited to the symptomatic diuretic therapy, the treatment of comorbidity and possible revascularization. Patients with HFpEF are a very heterogeneous group of patients. Due to the aging of the population in general, the number of patients increases and, accordingly, the role of a nurse in a team that participates in the treatment of patients suffering from HFpEF becomes even more important. With their knowledge and skills, nurses greatly contribute to the early diagnosis of HFpEF and are indispensable members of a team regarding the acute and chronic care for individuals suffering from this syndrome. Educating both patients and their families about the importance of regular exercise, healthy eating habits, regular use of diuretic therapy and adequate individualization of self-care guidelines is the key to improving the quality of life of patients with HFpEF, as well as a part of nursing activities in a multidisciplinary team during the care for patients.

    Cardiologia Croatica
    Back to search

    Heart failure with preserved left ventricular ejection fraction

    Extended Abstract
    Issue11-12
    Published
    Pages502
    PDF via DOIhttps://doi.org/10.15836/ccar2018.502
    heart failure
    education

    Authors

    Marin Žilić*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Danijela GrgurevićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Heart failure (HF) is a clinical syndrome that occurs as a consequence of cardiac function and structure disorders, resulting in insufficient oxygen supply to the tissue and the inability to satisfy the metabolic needs of the body. The main characteristics of this syndrome are repeated hospitalizations, negative impacts on the quality of the patient’s life, an unfavorable outcome and a large economic burden on the health system. According to the values of the left ventricular ejection fraction (LVEF) heart failure can be divided into HF with reduced LVEF (HFrEF, LVEF <40%), HF with a medium range LVEF (HFmEF, LVEF 40-49%), and HF with preserved LEVF (HFpEF, LVEF >50%). Nearly half of all patients suffering from HFpEF and the incidence of HFpEF increases steadily in developed countries, primarily due to the increase of risk factors, specifically life expectancy, female gender, hypertension, diabetes, kidney failure and obesity. ( 1 ) First symptoms and signs of HFpEF occur during strain, stress or exercise. Atrial fibrillation (AF), as one of the comorbidities, leads to reduced left atrial (LA) filling, while long term untreated AF results in mechanical and electrical cardiac dyssynchrony. Elevated LA pressure leads to pulmonary hypertension which results in increased pressure values in the right ventricle and consequently affects the negative remodeling of the right ventricle and, eventually, right ventricle failure. HFpEF is diagnosed on the basis of the present symptoms and signs of HF as well as the results of echocardiography EF > 50%, increased LA, pulmonary hypertension, electrocardiogram, xhest X-ray and value of NT-proBNP. The treatment of HFpEF is limited to the symptomatic diuretic therapy, the treatment of comorbidity and possible revascularization. Patients with HFpEF are a very heterogeneous group of patients. Due to the aging of the population in general, the number of patients increases and, accordingly, the role of a nurse in a team that participates in the treatment of patients suffering from HFpEF becomes even more important. With their knowledge and skills, nurses greatly contribute to the early diagnosis of HFpEF and are indispensable members of a team regarding the acute and chronic care for individuals suffering from this syndrome. Educating both patients and their families about the importance of regular exercise, healthy eating habits, regular use of diuretic therapy and adequate individualization of self-care guidelines is the key to improving the quality of life of patients with HFpEF, as well as a part of nursing activities in a multidisciplinary team during the care for patients.