cardiovascular remodeling and it's prevention,hypertension,anti hypertensive drugs

1. Good Afternoon

2. ROLE OF DRUGS IN PREVENTING THE REMODELING OF CARDIOVASCULAR SYSTEM IN FOLLOW UP OF HF PATIENT ROLE OF DRUGS IN PREVENTING THE REMODELING OF CARDIOVASCULAR SYSTEM IN FOLLOW UP OF HF PATIENT PRESENTED BY- SUBRATA DAS ASISH BARUI

3. HEART FAILURE Definition- This is a clinico-pathological condition in which heart cannot maintain adequate cardiac output to meet the Metabolic demand of the tissue in response to normal venous reterurn

5. Cardiac output must increase

6. Activation of neurohormonal axis

7. Norepi, AVP, angiotensin II, endothelin

8. Chronic NH release is dysfunctional

9. Alterations in HR, contractility

12. CHF Vicious Cycle LOW CARDIAC OUT PUT Increased Preload Increased Afterload Norepinephrine Increased Salt Vasoconstriction Renal Blood Flow Renin Angiotension I Angiotension II Aldosterone

13. Circulating and local (tissue) RAS influence on the cardiovascular system Circulating RAS Short-term effects Local RAS Long-term effects Intraglomerular hypertension Sodium/water reabsorption via aldosterone secretion Vascular hypertrophy by Increase production of growth factors & extracellular matrix ANGIOTENSIN II Vasoconstriction Positive chronotropic effects/ arrhythmogenic effects Myocardial hypertrophy Heart Heart

15. Hypertrophy

17. DRUGS & DOSE

20. CONCLUSION Myocardial & vascular remodeling is sing of progressive heart failure Prevention of remodeling is proven benefit using ACE inhibitor, beta blocker & digitalis.

21. Thank You….

22. QUESTIONS?