课件：心力衰竭发生的机制.ppt

分类 * 心力衰竭时机体代偿反应 * 心肌肥大（myocardial hypertrophy ） 心率加快的 * 增加前负荷 心肌肥大（myocardial hypertrophy ） * or myocardial remodeling心肌 代偿作用局限：，因此当心肌过度肥大但二者均可增加心脏作功和心输出量，使心功能在相当长的时间内处于稳定状态，不发生心力衰竭。 helix [hi:liks] 添加生词 改进词条 n. 螺旋, 螺旋状物, 耳轮 * 1 滑动能源，钙转运，mt 水肿，蛋白更新 钙储存蛋白结合钙?肥大心肌受磷蛋白磷酸化?, 心脏各部舒缩活动的协调性，导致心室活动不协调 * 可出现cardiac asthma 通气/血流比例失调 的呼吸困难 * 可出现cardiac asthma * 可出现cardiac asthma 3.夜间阵发性呼吸困难（ ) 控制水肿1.提高收缩性 2.改善舒张性 * Treatment of Heart Failure. Treatment scheme according to the degree of heart failure Patients with asymptomatic ventricular dysfunction should receive ACEI when the LVEF is significantly reduced, and clearly if it is less than 35%. In the presence of symptoms of heart failure, diuretics or neurohormonal inhibitors should be added. The use of digoxin remains controversial. In more advanced stages, in the presence of poorly controlled symptoms, newer drugs can be tried, reserving the inotropes for patients whose symptoms are uncontrollable with other medications. In any case, secondary prevention and assisting the patients in adapting to their limitations should remain in mind. * ?-Blockade decreases TNF-α and natriuretic peptides in HF patients treated with ACEI Content points: Ohtsuka et al evaluated the effect of β-blockade on circulating cytokine levels in patients with dilated cardiomyopathy.13 The study included 32 patients who had been treated with ACE inhibitors for 6 months. Baseline levels of TNF-α were significantly higher in patients than in control subjects and decreased significantly after 12 weeks of β-blockade. In another study, the same Japanese research team showed that plasma levels of the natriuretic peptides ANP and BNP decreased significantly after 6 months of β-blockade in HF patients treated with ACE inhibitors for 6 months.14 ACE inhibition has been shown to reduce IL-6, but demonstrated no effect on other inflammatory cytokines.15 It therefore appears that ACE inhibition and β-blockade have different mechanism