Drug Therapy for Heart Failure – Key Vocabulary

A set of 59 English vocabulary flashcards summarizing essential terms and definitions from the lecture on Drug Therapy for Heart Failure.

Heart failure

Condition of low cardiac output because the heart cannot pump enough blood to meet the body’s metabolic demands.

Cardiac output

Volume of blood the heart pumps per minute; reduced in heart failure.

Neurohormonal system

Feedback mechanisms involving the sympathetic nervous system and hormones that activate during hypoperfusion in heart failure.

Renin–Angiotensin–Aldosterone System (RAAS)

Hormonal cascade involving renin, angiotensin, and aldosterone that regulates blood volume and systemic vascular resistance.

Natriuretic peptide (NP) system

Family of hormones that promote natriuresis, diuresis, and vasodilation to counter fluid overload.

Preload

End-diastolic volume that stretches the ventricles; elevated by fluid overload in heart failure.

Afterload

Resistance the ventricles must overcome to eject blood; rises with arterial vasoconstriction.

Hypervolemia

Excess circulating blood volume that worsens heart failure.

Baroreceptors

Pressure sensors in the aortic arch and carotid sinus that modulate sympathetic tone; become blunted in heart failure.

Catecholamines

Fight-or-flight amines (epinephrine, norepinephrine, dopamine) that raise heart rate and contractility.

Inotropic effect

Influence that increases myocardial contractile force.

Chronotropic effect

Influence that alters heart rate.

Endothelin

Potent vasoconstrictor peptide released by endothelial cells; levels rise in heart failure.

Renin

Kidney enzyme released during low perfusion, converting angiotensinogen to angiotensin I.

Angiotensinogen

Liver-produced plasma protein substrate for renin.

Angiotensin I

Inactive peptide formed from angiotensinogen; converted to angiotensin II by ACE.

Angiotensin-converting enzyme (ACE)

Lung endothelial enzyme that transforms angiotensin I into angiotensin II.

Angiotensin II

Powerful vasoconstrictor that stimulates aldosterone, vasopressin, sympathetic activity, and cardiac hypertrophy.

Aldosterone

Adrenal cortex hormone that increases renal sodium and water retention.

Vasopressin (antidiuretic hormone)

Posterior pituitary hormone that promotes water reabsorption in kidneys.

Arterial vasoconstriction

Narrowing of arterioles that elevates afterload and cardiac workload.

Subendocardial ischemia

Reduced blood flow to the inner heart muscle layer due to high filling pressures.

Atrial natriuretic peptide (ANP)

Hormone released from atria with stretch, inducing natriuresis and vasodilation.

Brain natriuretic peptide (BNP)

Ventricular peptide released with wall stress; biomarker for heart failure severity.

Neprilysin

Neutral endopeptidase that degrades natriuretic peptides and angiotensin II.

Biomarker

Biological indicator of a disease process; BNP is one for ventricular dilation.

Systolic dysfunction

Impaired myocardial contractility during systole leading to reduced ejection fraction.

Diastolic dysfunction

Impaired ventricular relaxation and filling during diastole.

Heart failure with preserved ejection fraction (HFpEF)

Heart failure phenotype mainly due to diastolic dysfunction while ejection fraction remains normal.

Heart failure with reduced ejection fraction (HFrEF)

Heart failure phenotype due to systolic dysfunction with low ejection fraction.

Jugular vein distention

Visible neck vein bulging indicating elevated right-sided heart pressures.

Pulmonary rales

Crackling lung sounds from alveolar fluid linked to left-sided heart failure.

Peripheral edema

Swelling of extremities from venous congestion and fluid retention.

Angiotensin receptor–neprilysin inhibitors (ARNI)

Drugs combining neprilysin blockade with angiotensin receptor inhibition to improve heart failure outcomes.

Sacubitril/valsartan

ARNI combining sacubitril and valsartan used for moderate to severe heart failure.

Black Box Warning (for sacubitril/valsartan)

FDA alert that valsartan can impair fetal kidney function in 2nd–3rd trimester pregnancy.

Milrinone

Intravenous phosphodiesterase-3 inhibitor for short-term treatment of acute decompensated heart failure or cardiogenic shock.

Phosphodiesterase inhibitor

Drug class that increases intracellular cAMP, enhancing contractility and vasodilation.

Ivabradine

Medication that slows heart rate by inhibiting the sinoatrial node’s funny current; adjunct in heart failure.

Sinoatrial node modulator

Agent that directly alters pacemaker activity to reduce heart rate.

Angiotensin receptor blockers (ARB)

Drugs that block angiotensin II type 1 receptors, reducing blood pressure and afterload.

Mineralocorticoid receptor antagonists (MRA)

Aldosterone receptor blockers that lower sodium retention and limit cardiac remodeling.

Loop diuretics

Potent diuretics acting on the ascending loop of Henle to remove excess fluid.

Thiazide diuretics

Diuretic class acting on the distal convoluted tubule for mild fluid overload.

Aldosterone antagonists

Agents like spironolactone that counter aldosterone effects, reducing fluid and improving survival.

Beta-adrenergic blockers

Medications that inhibit sympathetic stimulation, lowering heart rate and myocardial oxygen demand.

Sodium–glucose cotransporter-2 (SGLT2) inhibitors

Drugs such as dapagliflozin and empagliflozin that lower heart failure morbidity and mortality.

Dapagliflozin

SGLT2 inhibitor shown to benefit patients with symptomatic heart failure regardless of diabetes status.

Empagliflozin

SGLT2 inhibitor that reduces hospitalization and death in heart failure patients.

Digoxin

Cardiac glycoside with narrow therapeutic index that increases contractility; no longer first-line.

Narrow therapeutic index

Small margin between effective and toxic drug concentrations, requiring close monitoring.

Cardiogenic shock

Critical state of extremely low cardiac output causing organ hypoperfusion; may require milrinone.

Fight-or-flight response

Sympathetic activation releasing catecholamines and increasing cardiovascular activity.

Ventricular hypertrophy

Thickening of ventricular muscle walls from chronic pressure or hormonal stimulation.

Ventricular dilation

Enlargement of ventricular chambers; reflected by elevated BNP levels.

Glomerular filtration rate (GFR)

Measure of kidney filtration; temporarily increased by natriuretic peptides.

Vasodilation

Widening of blood vessels that lowers vascular resistance and afterload.

Diuresis

Increased urine production that assists in removing excess fluid.

Exercise intolerance

Fatigue and dyspnea during activity; a cardinal symptom of heart failure.