Heart Failure Clinical Trial
Official title:
Non Invasive Assessment of Heart Failure
1. To Identify the role of aldosterone antagonist in patients of heart failure with
preserved ejection fraction.
2. Portray the health profile of heart failure patients admitted in internal medicine
department either heart failure with reduced ejection fraction or heart failure with
preserved ejection fraction.
3. To compare between patients of right and left sided heart failure by biomarkers and
parameters of echocardiographgy
4. Vitamin D and its relation to cardiovascular disease and heart failure.
Heart failure (HF) is a growing epidemic related to significant morbidity and mortality.
The prevalence of the disease continuously increases due to the ageing population and success
in treating cardiovascular diseases that often precede HF.
Lifetime risk of HF is still high with 20-45% and strongly age-dependent . Structural or
functional alterations in the heart lead to reduced cardiac output and rising intracardiac
pressures.
The resulting HF syndrome comprises typical symptoms such as dyspnoea, ankle swelling and
fatigue .
Heart failure is classified into right sided heart failure and left sided heart failure,the
later one is classified to HF with reduced EF (HFrEF) involving patients with an EF< 40% and
heart failure with preserved ejection fraction (HFpEF) The proportion of HFpEF seems to be
slightly lower than that of HFrEF .
For patients presenting with breathlessness, there is a need for a reliable biomarker for the
early diagnosis of heart failure. Similarly, there is also a need for better monitoring of
patients receiving treatment for heart failure. Non-invasive means such as a biomarker have
therefore become useful.
There are many potential biomarkers for heart failure, the investigators will discuss the
biomarkers that are available for clinical use in patients with heart failure to further
assess prognosis and possibly direct HF therapy.
There is evidence that aldosterone antagonists can oppose the effect of aldosterone in
promoting cardiac fibrosis.Furthermore, elevated levels of cardiac aldosterone have been
demonstrated in a rat model of hypertensive diastolic HF, and use of the aldosterone
antagonist, eplerenone, was associated with attenuation of left ventricular diastolic
dysfunction and reduction in left ventricular mass and fibrosis in this model.Thus,
aldosterone antagonism has the potential to be a beneficial therapeutic strategy in patients
with HFpEF.
Vitamin D has the potential to improve the symptoms ofheart failure (HF) and to modulate the
disease,Vitamin D supplementation can reduce blood pressure and improve skeletal muscle
function and strength.
Animal studies suggest that active vitamin D down-regulates the renin-angiotensin-aldosterone
system (RAAS), reduces retention of salt and water, and reduces myocardial hypertrophy.
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