课件：廖玉华阜外心肌病诊治进展英.ppt

* Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Moss DAAJ, Seidman CE, Young JB. An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention . Contemporary Definitions and Classification of the Cardiomyopathies. Circulation，2006，113:1807-1816 * Dilated cardiomyopathy (DCM) is an often fatal cause of heart failure. It has been recently confirmed that pathogenesis of DCM is related to autoimmune reaction. The process of DCM is usually developing gradually. Some patients are asymtomatic and yet have had left ventricular dilatation for months or even years. Autoantibodies mediated myocardium damage is a main pathogenesis in DCM, and the damage might be inhibited by calcium antagonist. We analyzed clinic materials of DCM from Chinese 16 hospitals and Intervention Study of Diltiazem in Dilated Cardiomyopathy (ISDDC). Our purpose were to research for clinical by stages in DCM and effects of intervention in different stages of DCM. * 治疗目的： 有效的控制心力衰竭和心律失常 缓解免疫介导的心肌损害 提高扩张型心肌病病人的生活质量和生存率 治疗方法： 1、心力衰竭的治疗 4、改善心肌代谢 2、心肌保护措施 5、栓塞、猝死的防治 3、抗病毒治疗 6、心脏移植 * β-受体阻滞剂 抗β1-受体抗体介导心肌细胞损害，早期进行美托洛尔治疗，会得到更好的疗效 适用于心率快、室性心律失常，抗β1-受体抗体阳性的病人 剂量：美托洛尔6.25mg Bid，逐渐增加到12.5～50 mg Bid * 钙拮抗剂 地尔硫卓治疗DCM适合于该病的早期 药理机制：干预抗体介导心肌损害和保护心肌 剂量：地尔硫卓30 mg tid * DiDi trial shows that the adjunct therapy of diltiazem improves cardiac function, exercise capacity, and subjective status without deleterious effects on transplant listing-free survival in patients with IDC. * We analyzed clinic materials of DCM from Chinese 16 hospitals，an Intervention Study of Diltiazem in Dilated Cardiomyopathy (ISDDC). Our purpose were to research for clinical by stages in DCM and effects of intervention in different stages of DCM. * * 扩张型心肌病心脏形态变化 * Dilated card