心力衰竭临床药物治疗面临的挑战-会议课件，教学幻灯，PPTPPT.ppt

李 勇 复旦大学华山医院心脏科 ;;Acute Infarction(hours);血液动力学的变化 (CO↓、LVEDP↑);ACEI治疗心力衰竭病死率和病残率;;;心率：心血管死亡的预测因子;Change in heart rate (bpm);总死亡率;4周 (41mg);Incomplete follow-up 102 withdrew consent 3 randomisation irregularities;Study design;选择性窦房结If通道阻滞剂对心率的影响;心肌梗死后静息心率减慢与临床获益;选择性窦房结If通道阻滞剂对主要终点的影响;患者基线时的治疗;;心力衰竭患病率;心力衰竭患者中HF-PEF的比例;HF-PEF患病趋势 ;SHF与HF-PEF的预后(5年生存率)OWAN TE et al. N Engl J Med 2006; 355: 251-259;;I-PRESERVE: Primary EndpointDeath or protocol specified CV hospitalization (Mean follow-up 49.5 months);I-PRESERVE: Baseline Treatments;Adapted with permission from: Vasan RS, Levy D. Arch Intern Med. 1996;156:1790.;V-HeFT: 血浆去甲肾上腺素水平与病死率的关系;BNP (pg/ml);Heart Failure after MI and HTN Systolic vs Diastolic;高血压-左心室肥厚-交感神经活性;药物对肾素血管紧张素系统的作用;ACEI (yes) BB (yes);肾上腺素系统 活化;CHARM-Added: 预设亚组, 心血管死亡或心力衰竭住院;From Risk Factors to Heart FailureTo treat heart failure, the BEST WAYis to PREVENT heart failure;血压