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Phy Sci 111B > M2 L4 > Flashcards

M2 L4 Flashcards

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1
Q

What is heart failure

A

the inability to pump
blood efficiently enough to meet the body’s
demands or to do so while causing elevated
filling pressures

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2
Q

Heart failure symptoms?

A

High left ventricular pressure can occur at rest or during exertion, leading to symptoms such as breathlessness,
fatigue, and exercise intolerance

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3
Q

HFpEF Pathophysiology:

A
  • LV hypertrophy, impaired LV diastolic filling, and raised
    ventricular filling pressure
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4
Q

How to confirm left ventricular diastolic dysfunction

A

an echocardiography

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5
Q

What is an echocardiography

A

non-invasive medical test that utilizes ultrasound to
visualize the heart in real time (it can be performed both at rest and after stress)

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6
Q

What does an echo assess?

A

It assesses heart chamber size, wall thickness, valve function, the rate of blood flow through the heart, and blood volume during diastole and systole to calculate cardiac pumping ability (SV or EF)

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7
Q

What is the 4 chamber view on an echo?

A
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8
Q

What is a long axis orientation view on an echo?

A

Myocardium thickness, rate of blood flow, diastole or systole occurrences, chamber size

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9
Q

What is Motion mode on an echo (m-mode)

A

Takes a cross-sectional view through the LV from base
to apex
○ Measures LV dimensions over time and wall thickness and chamber volume
○ Can place probe in various spots around disease

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10
Q

normal range for ejection fraction?

A

50-70

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11
Q
A
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12
Q

How to diagnose HFpEF with an echo?

A
  • need 4 chamber view
  • measure mitral valve inflow speed
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13
Q

What does the E wave represent in mitral valve flow on an echo?

A

The E wave represents the peak velocity of early diastolic filling through the mitral valve.

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14
Q

What does the A wave represent in mitral valve flow on an echo?

A

The A wave represents the velocity of late diastolic filling through the mitral valve.

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15
Q

Echo for HFpEF

What does a normal mitral valve flow look like (e & a)

A

E > A

The E wave (early diastolic filling) is faster than the A wave (late diastolic filling).

This means the heart fills primarily during early diastole.

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16
Q

Echo for HFpEF

What does a mildly dysfunctional mitral valve flow look like (e & a)

A

The A wave (late filling) becomes faster than the E wave, indicating a mild impairment in diastolic filling.

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17
Q

Echo for HFpEF

What does a moderately dysfunctional mitral valve flow look like (e & a)

A

The E wave remains faster than the A wave, but the A wave is reduced in speed, indicating moderate dysfunction.

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18
Q

Echo for HFpEF

What does a severely dysfunctional mitral valve flow look like (e & a)

A

The E wave is much greater than the A wave, and the A wave is severely diminished, indicating severe diastolic dysfunction.

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19
Q

What do beta blockers do to the heart

A

block adrenergic receptors on pacemaker cells and cardiomyocytes

leads to a decreased influx of sodium and calcium ions in the
cells, decreasing the rate of action potentials (heart rate), leading to an overall reduction in contraction rate and force (remember mechanisms
induced by cAMP!).

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20
Q

what do calcium channel blockers do to the heart

A

block L-type calcium channels, which prevents calcium influx into the cell, lowering overall cytosolic calcium.

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21
Q

What does digoxin do

A

increases contractility by increasing sodium influx, leading to a higher rate of calcium in the cell.

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22
Q

What do Angiotensin-converting enzymes (ACE) do?

A

keeps BP low by preventing vasoconstriction

prevents the conversion of angiotensin I to angiotensin II, which leads to vasoconstriction of vessels and
increases blood pressure.

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23
Q

What do beta blockers do to BP

A

blocking sympathetic activation of smooth muscle cells in arteries, leading to less vasoconstriction.

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24
Q

what do calcium channel blockers do to BP

Study These Flashcards
A

blocking calcium is necessary for smooth muscle cell contraction in the vessels.

25
Angiotensin Converting Enzyme Inhibitors (ACEi) examples by name
Lisinopril and Enalapril (ACEi), Losartan and Valsartan (ARBs), Sacubitril/Valsartan (Entresto, ARNIs)
26
What do adrenergic blockers do?
lower heart rate and blood pressure by inhibiting vasoconstriction Inhibits epinephrine/norepinephrine binding to the -adrenergic receptor, limiting cardiomyocyte contractility and smooth muscle cell contraction
27
example of adrenergic blockers by name
Atenolol, Propanolol, Metoprolol (Lopressor)
28
What happens if you combine beta-blockers and Angiotensin II-inhibitory drugs
lowers heart rate and contractility while reducing vascular resistance (decreased afterload and preload). These drugs decrease the cardiac workload or contraction force that needs to be overcome to eject blood efficiently, increasing the patient's survival following myocardial infarction or other heart diseases
29
which drugs inhibit things to decrease blood pressure by preventing vasoconstriction of blood vessels
Angiotensin Converting Enzyme Inhibitors (ACEi) Angiotensin Receptor Blockers (ARBs) Angiotensin Receptor-Neprilysin Inhibitors (ARNIs)
30
How do calcium channel blockers work?
lower blood pressure by preventing Ca2+ influx Block slow L-type calcium channels, slowing the conduction activity of pacemaker cells and, therefore, cardiomyocyte contractility
31
calcium channel blockers examples by name
Verapamil, Amlodipine, Felodipine
32
How does digoxin work?
lowers heart rate but also increases heartbeat strength (cardiac glycoside derived from the plant foxglove) * Increases intracellular sodium and calcium by inhibiting the sodium-potassium ATPase pump, activating the sodium-calcium exchanger, respectively * Slows down conduction by inhibiting the AV node (vagomimetic); overall leads to better blood circulation and reduced swelling
33
What do diuretics do?
remove excess fluid from the body and lower blood pressure to lower blood pressure
34
How do diuretics work?
Removal of salt and water by the kidneys
35
Example of diuretics by name
Thiazide: Chorthalidone kidneys: Furosemide Potassium: Amiloride
36
What do Mineralocorticoid Receptor Antagonists (MRAs) do?
block the action of aldosterone, a hormone that regulates salt and water balance, leading to increased excretion of salt and water from the kidneys
37
What are Sodium-Glucose Co-transporters 2 Inhibitors (SGLT2i) ?
a Type II diabetic drug that prevents glucose reabsorption in the kidneys, having a diuretic effect (increased diuresis)
38
How do Sodium-Glucose Co-transporters 2 Inhibitors (SGLT2i) work?
Removal of plasma volume and lowering of blood pressure can lead to cardiovascular benefits, such as reducing the risk of hospitalization or cardiovascular death in patients with or without diabetes, such as HFpEF patients
39
How does HFpEF help reduce heart failure symptoms?
signals to body that ur full and stimulates insulin production which lowers BG. also improves exercise capacity
40
How do premenopausal females differ in cardiac protection compared to males?
Premenopausal female subjects show protection against adverse remodeling, maintain better cardiac function, and experience reduced mortality.
41
How does LV mass change with age in males and females?
LV mass decreases with age in males and females, but female hearts are larger on average during aging due to significant aging-associated LV hypertrophy (concentric hypertrophy).
42
How does the number of ventricular CMs differ in adult males and females?
Adult males have fewer ventricular CMs, possibly due to testosterone-induced apoptosis (cell death).
43
How do endothelial cells differ in adult males compared to females?
Adult males have an increase in endothelial cells.
44
What is the relationship between higher circulating E2 levels and heart disease incidence?
higher circulating levels of 17β-estradiol (E2) are inversely correlated with heart disease incidence. This means that higher levels of E2 are associated with a lower risk of heart disease.
45
How does circulating dihydroxytestosterone (DHT) differ between male and female children and adults?
Circulating DHT is similar in male and female children, increases in male adults, and begins to decline slightly starting at age 40.
46
What signaling pathway is enhanced in female hearts that improves calcium handling and contractility? What does it do
The PKA (Protein Kinase A) signaling pathway. It will lead to better calcium handling and improved contractility.
47
What does increased Akt signaling in female hearts help prevent?
Fibrosis, apoptosis, maladaptive hypertrophy, and inflammation.
48
What effect does estrogen (E2) have on Gsα protein levels? what does this do?
Estrogen increases Gsα levels. Activates adenylyl cyclase → cAMP → PKA → improves calcium handling and contractility.
49
What does the RTK–PI3K–Akt pathway regulate in heart cells?
Protein synthesis and degradation; promotes cell survival.
50
What receptor allows estrogen (E2) to trigger fast, non-genomic effects?
GPER (G-protein-coupled Estrogen Receptor).
51
What happens when estrogen binds to ERα?
ERα translocates to the nucleus and binds EREs to regulate gene expression.
52
How does DHT influence gene expression?
DHT-AR complex binds androgen response elements (AREs) in DNA to regulate transcription.
53
What causes hypertensive stress in the heart?
Chronic high blood pressure or aortic narrowing (aortic stenosis), leading to left ventricular pressure overload.
54
What is pathological cardiac remodeling?
Structural changes in the heart due to chronic stress that can lead to dysfunction or heart failure.
55
How do females' hearts respond to hypertensive stress?
Females maintain higher left ventricular (LV) pressures and develop concentric remodeling (increased LV wall thickness).
56
How do males' hearts respond to hypertensive stress?
Males develop rapid left ventricular (LV) dilation and increased extracellular matrix (ECM) deposition.
57
What are Life's Essential Eight?
Dont No-one Suck Big Boy Penis Before Money 1) Diet 2) Nicotine exposure 3) Sleep health 4) Blood lipids 5) Blood glucose 6) Physical activity 7) Blood pressure 8) Manage Weight
58
Life's Essential Eight What does blood lipids refer to
attention to non-high-density lipoprotein cholesterol or LDLs (not just overall cholesterol). Easier to measure in fasting states

Phy Sci 111B (10 decks)

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