心力衰竭诊断新技术的临床评价施仲伟会议ppt课件教学幻灯.pptVIP

心力衰竭诊断新技术的临床评价;ESC 2008 心力衰竭：新的定义;Two-dimensional echocardiography with Doppler should be performed during initial evaluation of patients presenting with HF to assess left ventricular ejection fraction (LVEF), left ventricle size, wall thickness, and valve function. Radionuclide ventriculography can be performed to assess LVEF and volumes. 心力衰竭患者的初次评价应包括二维超声心动图和多普勒检查，评估左室射血分数、左室大小、室壁厚度和瓣膜功能。核素心室造影术可用于估计左室射血分数及容量。;超声心动图异常与心力衰竭（1）;Echocardiographic Tissue Doppler Imaging Is a Powerful Independent Prognosticator of Mortality in the General Population ;Survivors;;Kaplan-Meier Survival Plot for the Eas-index;Patients with LVEF ? 35%, sinus rhythm, and NYHA functional class III or ambulatory class IV symptoms despite recommended, optimal medical therapy and who have cardiac dyssynchrony, which is currently defined as a QRS duration ? 0.12 seconds, should receive cardiac resynchronization therapy, with or without an ICD, unless contraindicated. 接受最佳药物治疗而LVEF ? 35%、窦性心律、心功能Ⅲ~Ⅳ级、心脏不同步（QRS ? 0.12s）的患者，应接受CRT治疗（安装或不装心内除颤器），除非有禁忌证。;498例有CRT适应证的患者;PROSPECT: Modest Sensitivity and Specificity and Great Variability;Resynchronization Therapy in Normal QRS (RethinQ) Study;Patients Baseline Characterizatics;Results: Peak VO2 by Sub-Group ;超声难以准确评价心脏不同步时的复杂畸变过程1例扩张性心肌病患者：TDI未见不同步、应变显示不同步;心力衰竭的生物标志物;786例不同程度的慢性心力衰竭患者 心功能Ⅰ~Ⅳ级，LVEF 5%~65%（平均25?10%） BNP3~8536 pg/ml（平均688?948 pg/ml）， 接受标准抗心力衰竭治疗 随访24个月，研究终点为任何原因的死亡 评价和肽素的预测价值、并与BNP和NT-proBNP相比较;;Kaplan-Meier plots: survival in patients grouped according to quartiles of plasma copeptin;心力衰竭的临床诊断