舒张性心力衰竭PPT.ppt

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2018-01-25 发布于江苏
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舒张性心力衰竭PPT.ppt

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舒张性心力衰竭PPT

Toranomon Hospital 第1回日中心血管 Clinical Aspects of Diastolic Heart Failure Shin-ichi Momomura, MD Cardiovascular Center Toranomon Hospital Tokyo, Japan Incidence of Heart Failure Framingham Heart Study J Am Coll Cardiol 1993;22:6A–13A Male Female Distribution of Left Ventricular Ejection Fraction: EuroHeart Failure Survey European Heart Journal (2003) 24, 442–463 What is Diastolic Heart Failure? Diastolic (Heart) Failure Heart failure due to diastolic dysfunction Heart Failure with Preserved or Normal　Systolic Function Cf) Systolic Heart Failure ≒ Epidemiology of DHF Prevalence of DHF Diagnostic Criteria Evaluation of LV function Prevalence Ghali FHS FS24% (UCG) 28% Taffet FHS EF45% (RNV) 43% Takarada FHS FS30% (UCG) 24% Vasan FHS EF50% (UCG) 51% Distribution of the severity of left ventricular systolicdysfunction by qualitative assessment Women Men European Heart Journal (2003) 24, 442–463 Prognosis of DHF and SHF (1) EF＜50% EF≧50% 78 59 58 44 51 35 44 32 36 29 16 15 1.0 0.8 0.6 0.4 0.0 0 1 2 3 4 5 6 0.2 Expected EF＜50% EF≧50% Survival Years Senni M. et al.：Circulation,98,2282,1998. P=0.279 Prognosis of DHF and SHF (2) Smith GL. JACC 2003;41:1510-8 Characteristics: Demographic Preserved EF (n=200) Depressed EF (n=213) p Value Age 73 + 11 70 + 11 0.004 Male gender 74(37%) 139(65%) 0.001 White race 158(79%) 159(75%) 0.30 Smith GL. JACC 2003;41:1510-8 Characteristics: Cardiac History Preserved EF (n=200) Depressed EF (n=213) p Value EF 60 + 8 28 + 10 0.0001 HF 128 (64%) 169 (79%) 0.001 Previous.hospitalization for HF 60 (30%) 94 (45%) 0.002 Years of HF 2.4 + 5.4 3.3 + 5.5 0.002 Hypertension 160 (80%) 139 (65%) 0.001 Arrhythmia 77 (39%) 112 (53%) 0.004 Pacemaker placement 20 (10%) 40 (19%) 0.01 Smith GL. JACC 2003;41:1510-8 Characteristics: Cardiac History Preserved EF (n=200) Depressed EF (n=213) p Value Chronic stable angina 66 (33%) 91 (43%) 0.04 Myocardial infarction 78 (39%) 118 (55%) 0.001 Cardiac catheterization 75 (38%) 123 (58%) 0.001 CABG 39 (2