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3.1 The role of ischaemic heart disease in heart failure
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Published:November 2023
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Abstract
Ischaemic heart disease represents the most important cause underlying the occurrence of heart failure. Pathophysiological mechanisms explaining the association between myocardial ischaemia and heart failure are multiple and complex, ranging from multivessel obstructive coronary artery disease (CAD) to microvascular dysfunction in the absence of obstructive CAD. Of importance, understanding the exact mechanism of disease is crucial to obtain a proper diagnosis and start appropriate therapy. For this reason, the beginning of this chapter analyses the pathophysiology of ischaemic heart failure across a wide spectrum of heart failure presentations, from heart failure with reduced ejection fraction to heart failure with preserved ejection fraction. The chapter then discusses the diagnostic approach to the patient with heart failure of suspected ischaemic origin. Finally, the chapter reports on the evidence supporting the currently available therapeutic options, highlighting the knowledge gaps in management of these patients.
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