FAILURE
Definisi
Heart failure (HF) is a progressive clinical syndrome caused by inability of the heart to pump
sufficient blood to meet the body’s metabolic needs. (Dipiro 2015)
Heart failure (HF) “is a complex clinical syndrome that can result from any structural or
functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.”
This is further subdivided into HF with reduced left ventricular ejection fraction (LVEF) or HF
with preserved LVEF (HFPEF), previously referred to as diastolic dysfunction. (koda kimble,
2014)
DIASTOLIC DYSFUCTION
reduced muscle mass
(eg,
myocardial infarction [MI]),
restriction in ventricular
filling
dilated cardiomyopathies,
HEART FAILURE
and ventricular
hypertrophy
increased ventricular stiffness,
ventricular hypertrophy, infiltrative
SISTOLIC DYSFUCTION
myocardial diseases, myocardial
ischemia and MI, mitral or tricuspid
valve stenosis, and pericardial
decreased disease
contractility
cardiac function decreases after
myocardial injury
compensatory
mechanism
HF
MRAs (spironolactone and eplerenone) block receptors that bind aldosterone and,
with different degrees of affinity, other steroid hormone (e.g. corticosteroids,
androgens) receptors
Antagonis aldosteron mengurangi perawatan rumah sakit karena perburukan
gagal jantung dan meningkatkan kelangsungan hidup
DIURETIC
– Pada pasien gagal jantung dengan fibrilasi atrial, digoksin dapat digunakan
untuk memperlambat laju ventrikel yang cepat, walaupun obat lain (seperti
penyekat beta) lebih diutamakan
– Pada pasien gagal jantung simtomatik, fraksi ejeksi ventrikel kiri ≤ 40 %
dengan irama sinus, digoksin dapat mengurangi gejala, menurunkan angka
perawatan rumah sakit karena perburukan gagal jantung,tetapi tidak
mempunyai efek terhadap angka kelangsungan hidup (kelas rekomendasi
IIb, tingkatan bukti B)