(内科学教材）04.心力衰竭.pptVIP

;Heart Failure ;2016 ESC Guidelines for the diagnosis andtreatment of acute and chronic heart failure;Introduction;What is the causes for HF?;中华医学会心血管病学分会对我国42家医院CHF住院病历进行回顾分析; Heart Failure:;Relationship between cardiac dysfunction, HF and HF rendered asymptomatic;Myocardial injury;Ventricular Remodeling;Neurohormonal Activation;;;;Classification of CHF ;;Heart Failure :Diagnosis;Assessments in all cases Necessary Supports Opposes History with symptoms +++ If absent Objective evidence +++ If absent Response to treatment ++ ;;;;;Additional Tests for Diagnosis;Test to Exclude Alternatives;Electrocardiography;Chest X-ray;Echocardiography;B-type Natriuretic Peptides(BNP);B-type Natriuretic Peptides(BNP);B-type Natriuretic Peptides(BNP);;;;;1750;The medical treatment of heart failure has undergone a remarkable transition in the past 10 years . The approach has changed from a short-term hemodynamic / pharmacological paradigm to a more long-term reparative strategy that aims to favorably alter the biological proportion of the failing heart Bristow MR Circulation 2000 ;;Management Outline;Guidelines Treatment - Contents;General Measures and Advice;General measures and advice;General measures and advice;Pharmacological therapyfor CHF;;;;;;;A conerstone in the treatment of CHF;ACE-I:a meta-analysis of 32 clinical trials;;;How to use an ACEI in heart failure;How to use an ACEI in heart failure;ACEI: Contraindications;ACEI:Potential adverse effects;Angiotensin receptor blockers (ARBs);ARBs:Contraindications;ARBs;ARBs:Potential adverse effects;;;Placebo-controlled trials with beta-blockers in heart failure;;;;β-Blocker;Potential adverse effects of b-blocker;;;;Administration and Dosing Considerations with Spironolactone;How to use diuretics in heart failure;Loop Diuretics, Thiazides and Metolazone;Potassium-sparing Diuretics;“叠加”疗法治疗心衰降低死亡率;Digitalis Glycosides;Vasodilators;Positive Inotropes;Antiarrhythmics in He