Which statement best describes a goal of heart failure management to reduce myocardial oxygen demand?

Which statement best describes a goal of heart failure management to reduce myocardial oxygen demand?

• A. Increase preload and afterload
• B. No change in hemodynamics
• C. Decrease preload and afterload
• D. Increase contractility

Answer: (C)

The key idea is that myocardial oxygen demand in heart failure largely depends on wall stress and the work the heart must do to eject blood. Reducing the volume the ventricle has to handle (preload) and the pressure against which it must pump (afterload) lowers wall tension and the heart’s workload, thereby decreasing oxygen consumption. By using strategies that unload the ventricle—diuretics to reduce preload and vasodilators to reduce afterload—you lessen the myocardial oxygen demand and improve efficiency. Increasing preload or afterload would raise wall stress and the heart’s work, increasing oxygen needs. Increasing contractility often boosts cardiac output but also raises oxygen demand, which isn’t the primary goal when aiming to ease myocardial workload. A plan that leaves hemodynamics unchanged wouldn’t address the goal of lowering myocardial oxygen consumption. So, decreasing preload and afterload best fits the objective of reducing myocardial oxygen demand.

The key idea is that myocardial oxygen demand in heart failure largely depends on wall stress and the work the heart must do to eject blood. Reducing the volume the ventricle has to handle (preload) and the pressure against which it must pump (afterload) lowers wall tension and the heart’s workload, thereby decreasing oxygen consumption. By using strategies that unload the ventricle—diuretics to reduce preload and vasodilators to reduce afterload—you lessen the myocardial oxygen demand and improve efficiency.

Increasing preload or afterload would raise wall stress and the heart’s work, increasing oxygen needs. Increasing contractility often boosts cardiac output but also raises oxygen demand, which isn’t the primary goal when aiming to ease myocardial workload. A plan that leaves hemodynamics unchanged wouldn’t address the goal of lowering myocardial oxygen consumption.

So, decreasing preload and afterload best fits the objective of reducing myocardial oxygen demand.