tareq alobaidy, amtenan (2020-03-11)

heart failure (HF) with reduced ejection fraction (rEF) affects millions and is the most common reason for heart transplantation , which it happens when the left side of the heart doesn't pump blood out to the body as well as normal. It's sometimes called systolic heart failure. This is because of the left ventricle doesn't squeeze forcefully enough during systole, which is the phase of the heartbeat when your heart pumps blood. The types of heart failure are based on a measurement called the ejection fraction. The ejection fraction measures how much blood inside the ventricle is pumped out with each contraction. The left ventricle squeezes and pumps some (but not all) of the blood in the ventricle out to your body. A normal ejection fraction is more than 55%. This means that 55% of the total blood in the left ventricle is pumped out with each heartbeat.


Hypohydration, defined as a state of low body water, increases thirst sensations , (1) then force renin–angiotensin–aldosterone system (RAAS) which is a complex system that plays an important role in maintaining haemodynamic stability in the human body through regulation of arterial blood pressure, water and electrolyte balance. (3) RAAS has been implicated with the pathophysiology of various cardiovascular disorders including hypertension, acute myocardial infarction (AMI), congestive heart failure (CHF) reduced ejection fraction (REF) and stroke. Here, we review the role of active renin, a crucial, upstream enzymatic regulator of the RAAS, as a prognostic and diagnostic plasma biomarker of heart failure with reduced ejection fraction (HFrEF) progression , Clinical and experimental studies indicate that plasma renin activity is elevated with HFrEF . Modulation of renin activity in experimental HF significantly reduces edema formation and the progression of systolic dysfunction and improves survival. Thus, specific assessment and targeting of elevated renin activity may enhance diagnostic and therapeutic precision to improve outcomes in appropriate patients with HFrEF. (2)

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