Target heart rate in various conditions and disease states- Elias Hanna

0:00 Physiology of cardiac output at rest and exercise, and roles of Bowditch phenomenon and Frank-Starling relationship
5:37 Heart rate physiology in HFrEF
10:19 Heart rate physiology in HFpEF
13:08 Heart rate physiology in atrial fibrillation
21:18 Summary slide: target heart rate in various conditions

[@ahmeddaoud9901]

Thanks a lot for answering daily Question at ICU in professional way

[@richardfisher9916]

Fantastic talk. Thank you for sharing.

[@munirabdullatif2022]

Useful presentation.. Thank you Hanna

[@abdulrahmanarabi1838]

Wonderful, thank you from Qatar

[@moustafakamalsaad2293]

thank you very much, this is very useful and beneficial

[@firas4895]

Such a great experience, What is the effect of heart rate on bigeminy patients, and does increase hr during excersie increase syncopal attack

[@antoniolewis3162]

Amazing! im a CV fellow in florida and have found your videos EXTREMELY HELPFUL! please keep it up!! Do you think you can make a lecture on HR targets for VALVULAR disease? IE AI and MS need higher heart rates, finding it difficult to tease out effects of HR for AS and MR? thanks!!!

[@eliashanna8248]

My pleasure, thank you. I have hemodynamic videos regarding MS (kzbin.info/www/bejne/Z5CbnXmfjNulhsU), AI (kzbin.info/www/bejne/enfFpIupg8qksNk), and AS (kzbin.info/www/bejne/bZ2YnHWblsSLf80), and I allude to the heart rate effect in those. Regarding MS, you never want higher heart rate: in MS, the gradient is very dependent on heart rate, and can dramatically rise with faster rates, as diastolic emptying time declines. Thus, MS is one of 2 conditions where acutely slowing the heart rate in the midst of pulmonary edema can actually be helpful (the other condition being HOCM, where the obstruction is dynamic and worse with higher inotropism and lower preload). Conversely: decompensated AI needs a higher heart rate, as well as decompensated AS and MR, to increase cardiac output. For AS specifically, the gradient may increase during sinus tachycardia if inotropism and stroke volume is also increased (Bowditch phenomenon), while it often decreases during AF, as AF reduces the stroke volume and the overall cardiac output. Hence, it is important to distinguish fast rate from sinus tachycardia vs AF