慢性心力衰竭必威体育精装版指南解读-.ppt

慢性心力衰竭必威体育精装版指南解读 田野 教授 哈尔滨医科大学附属二院心内科 ESC-51 COUNTRIES Content Definition and diagnosis Diagnostic techniques Non-pharmacological management Pharmacological therapy Devices and surgery Co-morbidities and special populations Definition and diagnosis “The very essence of cardiovacular medicine is the recognition of early heart failure” Definition of HF Importantly, it was emphasised that the diagnosis is not dependent on a certain ejection fraction (EF), although it has implications for prognosis. Common clinical manifestations Clinical manifestations Classification of HF Common causes of HF Coronary heart disease Many manifestations Hypertension Often associated with left ventricular hypertrophy and ejection fraction Cardiomyopathies Familial/genetic or non-familial/non-genetic (including acquired, e.g. myocarditis) Hypertrophic (HCM), dilated (DCM), restrictive (RCM), arrhythmogenic right ventricular (ARVC), unclassified Drugs β-Blockers, calcium antagonists, antiarrhythmics, cytotoxic agents Toxins Alcohol, medication, cocaine, trace elements (mercury, cobalt, arsenic) Endocrine Diabetes mellitus, hypo/hyperthyroidism, Cushing syndrome, adrenal insufficiency, excessive growth hormone, phaeochromocytoma Nutritional Deficiency of thiamine, selenium, carnitine. Obesity, cachexia Infiltrative Sarcoidosis, amyloidosis, haemochromatosis, connective tissue disease Others Chagas disease, HIV infection, peripartum cardiomyopathy, end-