Non Invasive Assessment of Heart Failure
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.
Inclusion Criteria:

 1. clinical diagnosed heart failure dyspnea grade III or IV

 2. Heart failure with ejecton fraction ≤40

 Exclusion Criteria:

 1. Acute coronary syndrome.

 2. Active infection

 3. Chronic kidney diseased patients

 4. Conn's disease