1. Heart Failure Department of Cardiology, 2nd Affiliated Hospital Deng-feng Geng

2. Heart failure is the pathological process in which the systolic or/and diastolic function of the heart is impaired, and as a result, cardiac output decreases and is unable to meet the metabolic demands of the body. Definition

11. Pathophysiological Mechanisms

12. Pathophysiological Mechanisms

13. Pathophysiological Mechanisms

17. Ventricular Remodeling Ventricular remodeling after acute infarction Ventricular remodeling in diastolic and systolic heart failure Initial infarct Expansion of infarct (hours to days) Global remodeling (days to months) Normal heart Hypertrophied heart (diastolic heart failure) Dilated heart (systolic heart failure)

18. Clinical classification According to the course of disease Acute HF Chronic HF According to the cardiac output (CO) Low-output HF High-output HF According to the location of heart failure Left -side heart failure (LHF) Right-side heart failure (RHF) Biventricular failure (whole heart failure) According to the function impaired Systolic failure Diastolic failure

19. Chronic Heart Failure

20. Left ventricular failure Pulmonary congestion + low cardiac output

26. Biventricular Failure LV failure + RV failure

28. What Are The Symptoms of Heart Failure?

29. What Are The Symptoms of Heart Failure?

30. JVP = jugular venous pressure

31. Edema

32. Ascites

33. HF—lab test Brain natriuretic peptide (BNP) >100 pg/ml Heart failure

34. Normal Heart Failure

35. Pulmonary edema Butterfly sign

36. Swan-Ganz catheter

42. Treatment Strategies of HF

55. Summary of drug treatment for CHF

58. The Donkey Analogy Ventricular dysfunction limits a patient’s ability to perform the routine activities of daily living…

59. Diuretics, ACE inhibitors Reduce the number of sacks on the wagon

60. Beta-blockers Limit donkey’s speed, thus saving energy

61. digitalis Like the carrot placed in front of the donkey

62. CRT/CRT-D Increase the donkey’s (heart) efficiency

67. Diastolic HF vs Systolic HF

68. Diastolic HF vs Systolic HF

74. Thank you for your attention ！