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Physiology of Disease > Diastolic Heart Failure > Flashcards

Diastolic Heart Failure Flashcards

1
Q

What are 5 causes of heart failure?

A

CAD
Cardiomyopathies
Infections
Valve disease
Electrical issues

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2
Q

What are 2 types of ventricular dysfunction?

A

Systolic - inadequate contractile function
diastolic - impaired relaxation & rdduced compliance

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3
Q

What is a common feature of both types of ventricular dysfunction?

A

Insufficient CO to meet demands of the body

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4
Q

What are 5 symptoms of HF?

A

Dilated pupils
falling O2 sat.
decreased BP
weak pulse
pitting edema

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5
Q

What is preload?

A

Volume of blood in ventricles at end of diastole

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6
Q

What is afterload?

A

Resistance left ventricle must overcome to circulate blood

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7
Q

What are 4 ways the heart compensates for ventricular dysfunction (pre-HF)?

A

Increase blood volume
RAAS
Increase HR
Increase CO

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8
Q

What happens to the renal system in HF?

A

Decreased renal perfusion
increased renal venous pressure
loss of renal function
increased NaH2O retention

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9
Q

What are 3 primary risk factors of DHF?

A

Hypertension
Diabetes
Obesity

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10
Q

What do Echo-Dopplers measure?

A

E wave

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11
Q

What is the E wave?

A

Reflects the speed of blood moving towards the apex

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12
Q

How can you measure the Ea wave?

A

Changing the settings to pick up higher amplitudes & lower velocities to measure tissue velocities

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13
Q

What does the Ea wave show?

A

Speed of the relaxing mitral annulus going away from the apex as the heart relaxes

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14
Q

What happens in diastolic dysfunction to the E and Ea wave?

A

E - high
Ea - low (stiffened heart tissue relaxes slowly)
E/Ea ratio is high (>13)

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15
Q

What are 4 characteristics of the ECM?

A

Collagen deposition
collagen quality
collagen cross linking
fibroblast activation

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16
Q

What are 3 myocyte properties?

A

Ca2+ removal
cross-bridge detachment
titin mechanics

17
Q

What are 4 serum markers for collagen turnover?

A

PINP
PIIINP
PICP
CITP

18
Q

What are 3 serum markers for ECM remodelling?

A

MMP-2
MMP-9
TIMP-1

19
Q

What are 4 serum markers inflammation?

A

IL-6
IL-8
TNFalpha
MCP-1

20
Q

What are 4 pieces of evidence of fibrosis in DHF?

A

Increased collagen turnover in serum
Collagen deposition in human and animal model
Increased collagen cross-linking

21
Q

What influences relaxation in myocytes?

A

Speed of Ca2+ clearance

22
Q

What is titin?

A

Biggest protein in human - acts like a band (3MDa)

23
Q

What are titin’s 2 main isoforms in the heart?

A

N2B
N2BA (more compliant)

24
Q

What does isoform switching dictate?

A

Passive stiffness of myocyte

25
Q

What does post-translational modifications of titin affect?

A

Function (phosphorylation, oxidation)

Physiology of Disease (15 decks)

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