• Title/Summary/Keyword: HFpEF

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Beta Blockers in Contemporary Cardiology: Is It Better to Cast Them Out?

  • Javaid Ahmad Dar;John Roshan Jacob
    • Korean Circulation Journal
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    • v.54 no.4
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    • pp.165-171
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    • 2024
  • Beta blockers are one of the commonest prescription drugs in medicine and they have been thought to revolutionize the treatment of heart failure (HF) with reduced ejection fraction (HFrEF) in the last century. In addition to HFrEF, they are prescribed for a variety of diseases in cardiology from hypertension to HF, angina, and stable coronary artery disease (CAD). The increased prescription of beta blockers in conditions like HF with preserved ejection fraction (HFpEF), and stable CAD may be doing more harm than good as per the data we have so far. The available data shows that beta blockers are associated with increased stroke risk and atrial fibrillation (AF) in hypertension and in patients with HFpEF, they have been associated with decreased exercise capacity. In patients with stable CAD and patients with myocardial infarction with normal systolic functions, beta blockers don't offer any mortality benefit. In this article, we critically review the common indications and the uses of beta blockers in patients with HFpEF, CAD, hypertension and AF and we propose that beta blockers are overprescribed under the shadow of their beneficial effects in patients with HFrEF.

A Case of Pleural Effusion in a Patient with Heart Failure with Preserved Ejection Fraction Improved by A Combined Korean-Western Medicine Approach (좌심실 수축 기능 보전 심부전증으로 인한 흉수에 대한 한양방 복합치료 치험 1례)

  • Ha, Won Jung;Seo, Yuna;Lee, Young seon;Cho, Ki-Ho;Mun, Sang-Kwan;Jung, Woo-Sang;Kwon, Seungwon
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.22 no.1
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    • pp.45-56
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    • 2021
  • ■ Background Heart Failure with Preserved Ejection Fraction(HFpEF) is a heart failure that appears to have normal contraction function. In the case of HFpEF, no pharmacological therapy has been found to improve clinical prognosis, so it should be approached as an symptomatic treatment, therefore alternatives are needed due to concerns over adverse effects such as electrolyte imbalance caused by medication. ■ Case report A 81 year old female patient with Heart Failure with Preserved Ejection Fraction(HFpEF) patient complained dyspnea. Herbal prescription Mokbanggi-tang and Oryeongsan was administered on 6th day and 8th day respectively since the symptoms started. The NYHA Classification and Chest X-ray had been evaluated during the treatment period. Until the 7th day, the patient was classified as Class II, and when discharged from the hospital on the 28th day, it gradually improved and was classified as Class II. Chest X-Ray took on 2nd day showed pleural effusion and it was aggravated until 13th day. Follow up Chest X-Ray showed improving state of pleural effusion from 20th day and gradually got better. Mokbanggi-tang treatment continued for 52 days and stopped on 58th day. After Mokbanggi-tang treatment ended, only Oryeongsan treatment was maintained. ■ Conclusion The present case report suggests that Korean-Western medicine approach with Mokbangki-tang and Oryeongsan might be effective to pleural effusion and heart failure symptoms such as poor physical activity shown in a NYHA Classification. This shows that Mokbanggi-tang and Oryeongsan can be a therapeutic option as a treatment for patient with Heart Failure with Preserved Ejection Fraction(HFpEF).

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis

  • Jae Yeong Cho ;Dong-Hyuk Cho;Jong-Chan Youn;Darae Kim;Sang Min Park;Mi-Hyang Jung;Junho Hyun;Jimi Choi;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Byung-Su Yoo;Seok-Min Kang;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.4
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    • pp.195-216
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    • 2023
  • The Korean Society of Heart Failure guidelines aim to provide physicians with evidence-based recommendations for diagnosing and managing patients with heart failure (HF). In Korea, the prevalence of HF has been rapidly increasing in the last 10 years. HF has recently been classified into HF with reduced ejection fraction (EF), HF with mildly reduced EF, and HF with preserved EF (HFpEF). Moreover, the availability of newer therapeutic agents has led to an increased emphasis on the appropriate diagnosis of HFpEF. Accordingly, this part of the guidelines will mainly cover the definition, epidemiology, and diagnosis of HF.