如何优化心衰控制?-课件,幻灯,PPT.ppt
《如何优化心衰控制?-课件,幻灯,PPT.ppt》由会员分享,可在线阅读,更多相关《如何优化心衰控制?-课件,幻灯,PPT.ppt(45页珍藏版)》请在三一文库上搜索。
1、Keep guideline in mind, walking your own way !,Michael Fu, MD, PhD, FESC Professor, Senior Consultant Physician Head, Heart Failure Center Medicine Sahlgrenska University Hospital/Sahlgrenska Gteborg, SWEDEN,How to optimize heart failure management ?,Chronic Heart Failure More common than we believe
2、 !,2 %,10 %,CHF: A aged population,0,100,200,300,400,500,600,700,1960,1980,2000,2020,Millions,165,296,403,649,Chronic Heart Failure A disease state which seldom stops !,Risk factors: diabetes hypertension,Vascular dysfunction,Vascular disease,Tissue injury (MI, stroke),Pathological remodeling,Target
3、 organ dysfunction (HF, renal),Sympatikus Angiotensin II aldosterone,-,The Cardiovascular Continuum,Adapted 2003 from Dzau V, Braunwald E. Am Heart J. 1991; Gibbons 1999.,Heart failure,Death,Chronic Heart Failure More malignant than we believe !,CHF: More malignant than most cancer !,Stewart et al.
4、Eur J Heart Failure 2001, 3(3): 315-,Standard Heart failure care,Extraordinary measure,Risk modification,X,X,Chronic Heart Failure Worse than we believe in CHF treatment,diuretic digoxin,diuretic digoxin,diuretic digoxin ACE-I,diuretic digoxin ACE-I,diuretic digoxin ACE-I blocker,diuretic digoxin AC
5、E-I blocker,ACEI (1991), blocker (1999),ARB (2003),ACE-I, blocker,ARB,Evidence-based heart failure medications,One year mortality (%),Worldwide Gteborg blocker: 50 % 82 % ACEI: 64% 75 %,Age 80 years Worldwide Gteborg blocker: 15 % 80 % ACEI: 35% 73 %,European heat survey, Heart failure registry in G
6、teborg,A Gap between Guideline and Clinical Practice,Can we do better ?,To clarify objectives of treatment of chronic heart failure,Prognosis,Morbidity,Prevention,Life quality,No 1,Putting guideline into clinical prctice !,No 2,Evidence based medicine makes difference !,CHF,ACEI+BB,ESC,CHF,ACEI+BB,P
7、ersisting symptoms & sign,Yes,ARB or Aldosterone antagonist,ESC,CHF,ACEI+BB,Persisting symptoms & sign,Yes,ARB or Aldosterone antagonist,Persisting symptoms,Yes,QRS120 ms,Yes,CRT/CRT-D,ESC,CHF,ACEI+BB,Persisting symptoms & sign,Yes,NO,ARB or Aldosterone antagonist,Persisting symptoms,Yes,QRS120 ms,Y
8、es,CRT/CRT-D,NO,LVEF35%,Yes,ICD,ESC,CHF in particular Sudden death,Sudden Death,“The major challenge confronting contemporary cardiology”,Bernard Lown,Most common death in Hypertension Post-MI patients Heart failure,Sudden Death,Primary Prevention,Diu,Meto,5,10 (y),(n=3 234),Hypertension,50,Cumulati
9、ve No.,Sudden Death - Risk Reduction with Metoprolol,Secondary Prevention,Plac,Meto,(n=5 474),1,2,3 (y),Post Myocardial infarction,Tertiary Prevention,Plac,Meto CR/XL,6,12,18 (m),(n=3 991),Heart Failure,12,Cumulative No.,120,Olsson G et al Am J Hypertens 1991,Olsson G et al Eur Heart J 1992,MERIT-HF
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 如何 优化 心衰 控制 课件 幻灯 PPT
链接地址:https://www.31doc.com/p-2791752.html