Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

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Which parameter is mainly affected by reducing preload in heart failure management?

Heart rate
Stroke volume
Fluid volume
Oxygen demand

The correct answer is: Oxygen demand

Reducing preload in heart failure management primarily affects oxygen demand. Preload refers to the volume of blood in the ventricles at the end of diastole, which influences how much the heart stretches and contracts. In heart failure, the heart may struggle to pump adequately, leading to an increase in cardiac workload and oxygen demand. By reducing preload, through interventions such as diuretics or nitrates, the overall volume of blood returning to the heart decreases. This reduction lessens the amount of work the heart has to perform during contraction. Consequently, with a lower preload, the heart requires less oxygen to function efficiently because it is not working against an excessive volume of blood. This is crucial in managing heart failure, as it can help alleviate symptoms and reduce the risk of further cardiac strain. While heart rate, stroke volume, and fluid volume can also be affected by changes in preload, they are not the primary parameters of concern when focusing on oxygen demand management. A lower workload translates directly to decreased oxygen consumption by the heart muscle, making this parameter the main focus in the context of reducing preload.