慢性心力衰竭最新指南解读-课件，幻灯，PPT.ppt

慢性心力衰竭最新指南解读;ESC-51 COUNTRIES;Content;Definition and diagnosis;Definition of HF; ;Clinical manifestations;Classification of HF;Common causes of HF;Classification of HF;Diagnostic techniques; ; ;Diagnostic assessments supporting the presence of HF ;(BNP) in Differentiating between Dyspnea ;BNP among Patients in Each of the Four NYHA Classifications ;BNP;B-type natriuretic peptide (BNP);HF with preserved ejection fraction (HFPEF);HFPEF;Epidemiologic studies ;Assessment of HFPEF;Speckle-tracking echocardiography;Process underlying HFPEF;Non-pharmacological management;;People involved in care;The Players;Pharmacological therapy;ACE inhibitors;Mortality Reductions with ACEI;β-Blockers;Effect of β-Blockers on outcome;Aldosterone antagonists;Aldosterone antagonists in HF;ARBs;CHARM-Alternative trial;Digoxin;DIG TRAIL--All-cause mortality;Hospital admission for worsening HF;Diuretics;In symptomatic patients with an LVEF 40%, the combination of H-ISDN may be used as an alternative if there is intolerance to both an ACEI and an ARB. Adding the combination of H-ISDN should be considered in patients with persistent symptoms despite treatment with an ACEI, b-blocker, and an ARB or aldosterone antagonist. Treatment with H-ISDN in these patients may reduce the risk of death.;Other drugs-Statins;Trial design: A total of 5011 patients at least 60 years of age with New York Heart Association class II, III, or IV ischemic, systolic heart failure were randomly assigned to receive 10 mg of rosuvastatin or placebo per day Results: Primary Outcome: 11.4% with rosuvastatin vs. 12.3% with placebo (p = 0.12) Death from Any Cause : 11.6% vs.12.2% (p = 0.31), respectively Any cause Hospitalizations : 2193 vs. 2564 (p 0.001), respectively; ;N Engl J Med 2007;357:2248–2261.;Statin-mediated effects in endothelial cells and other tissues ;Class I recommendations For Drugs;Devices and surgery;ICD Prior resuscitated cardiac arrest (Class I Level A) Isc