课件：心脏再同步化治疗.pptVIP

CRT治疗改善生活质量和NYHA 分级 * P 0.05 1. NEJM 2002;346:1845-53 2. NEJM 2001;344:873-80 3. Eur Heart J 2002;23:1780-1787 4. /cdrh/pdf/P010012b.pdf. Accessed August 2, 2002 5. JAMA 2003; 289:2685-94 NYHA: 改善至少1级 平均生活质量评分变化 (MLWHF) CRT改善运动能力 * P 0.05 1. NEJM 2002;346:1845-53 2. NEJM 2001;344:873-80 3. /cdrh/pdf/P010012b.pdf. Accessed August 2, 2002 4. JAMA 2003; 289:2685-94 平均最大VO2变化 平均6分钟步行距离变化 Ml/kg/min 以上研究特别是2002年公布的MIRACLE研究表明CRT较单用药物组可以显著改善NYHA分级，6分钟步行距离，运动能力和生活质量。 CRT治疗是否可以降低死亡率？2005年3月ACC公布的里程碑意义的CARE HF 研究明确回答了这个问题：Yes！！！ ESC心衰指南将心衰列为CRT I类适应征！ 2005 ACC/AHA心衰指南将其列为CRT 的 I类适应征 2006年中国CRT指南 I类适应症 同AHA/ACC IIa类适应症 心房颤动合并其他CRT的I类适应症 结 论 对心衰合并收缩不同步的患者,CRT治疗降低死亡危险，改善症状和生活质量,减少并发症 以上益处是在标准药物治疗之外额外获得的 心脏再同步治疗应当在此类患者中常规运用 THANK YOU SUCCESS * * 可编辑 * * * * HF is a progressive disease with no therapeutic option to cure the illness. This graph shows the correlation between the severity of HF expressed by the 4 NYHA functional classes and survival as well as hospitalization. You can see a very clear decrease of survival (or in other words: an tremendous increase of mortality) and an increase in the frequency of hospital admissions with increasing NYHA function class. * * Treatment of Heart Failure. Drugs This is a simple and pragmatic classification of the vast numbers and types of medications in the pharmacopoeia for the treatment of heart failure. * As you can see from this diagram, heart failure is difficult to manage chronically. When a heart failure patient moves from a compensated state to a decompensated state, their symptoms increase. Subsequently, their medications are adjusted, and often hospitalization is required. After diuresis, the patient typically moves back to a compensated state until something occurs, such as eating too much salt, etc., which pushes them back to a decompensated state. * * Main purpose: Show that a large number of patients have been studied in completed and ongoing randomized controlled studies of CR