Heart Failure & Mechanical Circulatory Support

Question 1

ACC/AHA stages of HF?

Answer 1

A: at risk, no structural changes or Sx
B: Structural changes w/o Sx
C: Structural changes w/ Sx
D: Refractory Sx

Question 2

NYHA stages of HF?

Answer 2

I: No limitation
II: Slight limitation, ordinary physical activity
III: Marked limitation. Comfortable at rest but unable to do ordinary activity.
IV: Unable to carry out any physical activity w/o discomfort -OR- Sx at rest.

Question 3

Difference in timing for HF stages between ACC/AHA vs NYHA?

Answer 3

ACC/AHA can only progress forward, never backward. NYHA can move forward/backward.

Question 4

Effect of gender on pBNP level?

Answer 4

Women have higher pBNP levels.

Question 5

Effect of race on pBNP level?

Answer 5

Africans have lower pBNP levels.

Question 6

Medications that can decrease pBNP?

Answer 6

Coreg. Spironolactone.

Question 7

5 non-cardiac causes of pBNP elevation?

Answer 7

• Elevated age.
• Anemia
• Cor pulmonale
• Critical Illness
• Sepsis

Question 8

ESCAPE trial for PA catheters?

Answer 8

Safe and associated with better QoL, but had no mortality difference. Routine use not recommended, but OK for refractory cases.

Question 9

GDMT for HF? 4 components, 3 of which improve survival.

Answer 9

• Vasodilators (ACEI, ARB, Hydral, ARNi)
• BB (start when not acute)
• Device Tx (AICD)
• Aldosterone does not improve survival.

Question 10

Augmentation due to IABP?

Answer 10

10%