1-WHAT IS HEART FAILURE-Heart Failure 101 Chinese
慢性心力衰竭Chronic Heart Failure (双语)
心力衰竭分级
主观分级：Ⅰ、Ⅱ、Ⅲ、Ⅳ级（NYHA） NYHA classificatiy activity don't lead to inertia, dyspnea, palpitation. Ⅱ slight activity limit , no symptom at rest ,daily activity lead to inertia, dyspnea, palpitation or angina pectoris. Ⅲ obvious activity limit , no symptom at rest , daily activity lead to inertia, dyspnea, palpitation or angina pectoris. Ⅳ cannot do any activity , have symptom at rest.
Symptom
铺助检查
心电图electrocardiogram X-光胸片X-ray chest radiograph 血液测试 – Renal and hepatic function 心脏超声 – LVEDD and LVEF
Differential diagnostic of Chronic heart failure
心脏体征
全心衰竭Biventricular heart failure
右心衰竭继发于左心衰竭形成全心衰竭，当右心 衰竭出现后,左心衰竭肺淤血症状反而减轻，主要 表现为心排血量减少的相关症状和体征。
have clinical manifestation of left and right heart failure
④急性肺水肿acute pulmonary edema
全英文心衰PPT课件
Coronary
Caroterroynary
disaeratesery
disease
What causes heart failure
Heart attack
Cardiomyopathy
Overburdened
Compensation reaction
Compensation
reaction
•Cardiac hypertrophy •Compliance decrease
FrankStarling mechanism
Compensatory mechanism of Neurohumor
Types Of Heart Failure
Systolic dysfunction
When the heart muscle doesn't contract with enough force, there is less oxygen-
of HF
of HF
Structural heart
disease with prior or current symptoms
of HF
Refractory HF
requiring specialized
interventions
Stages of Heart Failure
Class I Class II Class III
No limitation during ordinary activity
Slight limitation by shortness of breath fatigue during
moderate exertion or stress
Symptoms with minimal exertion that interfere with
有关学习的英文名言
有关学习的英文名言本文是关于有关学习的英文名言，仅供参考，希望对您有所帮助，感谢阅读。
1、一份耕耘，一份收获。
No pains， a harvest。
2、三人行必有我师焉。
Keep good men company。
3、路曼曼其修远兮，吾将上下而求索。
Man， no， I will search up and down。
4、美貌和智慧很少结合在一起。
Beauty and wisdom rarely together。
5、只有受过教育的人才是自由的。
Only a person with education is free。
6、今天不想走，明天就要跑了。
Don't want to go today， tomorrow will be run。
7、人生没有失败，自信创造精彩。
A life without failure， confidence to create brilliant。
8、人行犹可复，岁月难可追。
Pedestrian Jude can be complex， difficult with time。
9、路，是自己走出来的；机会是自己创造出来的。
Road， is his own come out； Opportunity is created。
10、遇事做最坏的打算的人，是具有最高智慧的人。
He do the worst， is of the highest wisdom。
11、路漫漫其修道远，吾将上下而求索。
A long way to go the order， I will search up and down。
12、健康是智慧的条件，是愉快的标志。
Health is the condition of wisdom， is a sign of pleasure。
13、夜晚给老人带来平静，给年轻人带来希望。
Night to old people peace， hope for young people。
心梗后心衰英语
心梗后心衰英语Heart failure is a serious condition that can occur after a person experiences a heart attack. A heart attack, also known as a myocardial infarction, is caused by a blockage in one of the coronary arteries that supply blood to the heart muscle. This blockage results in damage to the heart muscle, which can then lead to the development of heart failure.Heart failure is a chronic and progressive condition in which the heart is unable to pump enough blood to meet the body's needs. This can result in a variety of symptoms, including shortness of breath, fatigue, swelling in the legs and feet, and an irregular heartbeat. Heart failure can be a debilitating and life-threatening condition, but with proper treatment and management, many people are able to live relatively normal lives.One of the most common causes of heart failure after a heart attack is left ventricular dysfunction. The left ventricle is the main pumping chamber of the heart, and it is responsible for pumping oxygenated blood to the body. During a heart attack, the blood supply to aportion of the left ventricle is cut off, causing damage to the heart muscle. This damage can result in the left ventricle becoming weakened and unable to pump blood as effectively as it should.Another potential cause of heart failure after a heart attack is remodeling of the heart. After a heart attack, the heart may undergo structural and functional changes in an attempt to compensate for the damage that has occurred. This remodeling process can involve the expansion of the left ventricle, thinning of the ventricular walls, and the development of scar tissue. These changes can further impair the heart's ability to pump blood effectively, leading to the development of heart failure.In addition to left ventricular dysfunction and heart remodeling, other factors can also contribute to the development of heart failure after a heart attack. These include the extent and location of the heart damage, the presence of other underlying medical conditions (such as high blood pressure or diabetes), and the individual's overall health and lifestyle factors.Diagnosing heart failure after a heart attack can be a complex process, as the symptoms can be similar to those of other conditions. Doctors will typically use a combination of physical exams, medical history, and diagnostic tests to make a diagnosis. These tests may include electrocardiograms, echocardiograms, and blood tests.Once a diagnosis of heart failure has been made, the next step is to develop a treatment plan. The primary goals of treatment are to manage the underlying condition, reduce the risk of further complications, and improve the patient's quality of life. Treatment options may include medications, lifestyle changes, and in some cases, surgery or other interventional procedures.Medications are often a cornerstone of heart failure treatment, and there are a variety of different classes of drugs that can be used. These include diuretics, which help to reduce fluid buildup in the body, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), which help to lower blood pressure and improve heart function, and beta-blockers, which can help to slow the heart rate and improve the heart's pumping ability.In addition to medications, lifestyle changes can also play an important role in the management of heart failure. This may include a healthy diet, regular exercise, weight management, and the avoidance of smoking and excessive alcohol consumption. These lifestyle changes can help to improve overall cardiovascular health and reduce the risk of further complications.In some cases, more advanced interventions may be necessary to treat heart failure after a heart attack. This may include the use ofdevices such as pacemakers or implantable cardioverter-defibrillators (ICDs) to help regulate the heart's rhythm, or the use of surgery to repair or replace damaged heart valves or to create a bypass around a blocked artery.Despite the challenges of living with heart failure after a heart attack, many people are able to manage their condition and maintain a good quality of life. With proper treatment and lifestyle modifications, many patients are able to live relatively normal lives and enjoy activities that they previously enjoyed.It is important to note, however, that heart failure is a serious and potentially life-threatening condition, and it is important for patients to work closely with their healthcare providers to develop a comprehensive treatment plan. This may involve regular check-ups, ongoing monitoring, and the prompt management of any new symptoms or complications that may arise.In conclusion, heart failure is a common and serious complication that can occur after a heart attack. While it is a challenging condition to manage, there are a variety of effective treatment options available, and many patients are able to live relatively normal lives with the proper care and support. By understanding the causes, symptoms, and treatment options for heart failure after a heart attack, patients and their healthcare providers can work together toimprove outcomes and enhance the quality of life for those affected by this condition.。
第06讲读后续写之“亲情友情类”主题(讲义)-高考英语一轮复习(新教材新高考)
►第06讲亲情+友情类（讲义）_____________________________________________________________________读后续写中常常会遇到人际关系及个人情感类的故事内容。
如：父子关系、母子关系、师生关系、同学友情、朋友关系等之间涉及家人、朋友、邻居、亲戚或他人之间的情感沟通或交流。
此类文章中常含有涉及个人的喜、怒、哀、乐、害怕、紧张、孤单、骄傲、喜悦等细节描写。
【写作步骤】一冲突和矛盾纠结1.2.His voice trembled with anger. 他的声音因愤怒而颤抖。
3.Filled with anger/fury(狂怒)，Tom was unable to utter a single word.Tom气得一句话也说不出。
4.Boiling with rage，Tom shook his fist at me.Tom怒火中烧，对我挥舞拳头。
5.Seeing this, he was filled/ bursting with anger.看到这些，他怒不可遏。
6.Feeling a great sense of jealousy welling up in her heart and surging through her, Jessica threw the can at the woman.Jessica 感到一股强烈的嫉妒在心中升腾、奔涌，她把易拉罐扔向那个女人。
7.What he said pierced my heart.他说的话刺痛了我的心。
8.He was filled/ bursting with anger and storm out of the room.他怒不可遏，气冲冲地走出了房间。
9.Finding Clark's note in a mess, his teacher was blue in the face.发现Clark的笔记一团糟，他的老师脸气得发青。
Congestive Heart Failure
Pathophysiology
Compensatory mechanism of cardiac dysfunction ( 心功能障碍的代偿机制 )
･increases preload ( 前负荷 )
• Increases sarcomere length ( 肌原纤维长度 )
• Increases end-diastolic blood volume
demands of the body.
• The cardinal manifestations of HF are
dyspnea (呼吸困难) , fatigue (疲劳) ,
fluid retention (液体的潴留 )
(2)
• In most patients HF is a progressive(进行性) disorder, with time,the symptoms of the
(3) Pulmonary embolism (肺栓塞 )
(4)Fatigue (疲乏 ): Intense prolonged exertion or severe fatigue, emotion stress or severe climatic change. (5) Others: Pregnancy or delivery, Anemia , hemorrhage, Fluid overload or endocrine disorders (thyrotoxicosis).
disease become increasingly severe.
• Once initiated, HF usually advances and leads to recurrent , need for hospitalizations , and finally going to die or sudden death ( 猝死 ) .
关于成功和失败的英语名言
关于成功和失败的英语名言本文是关于关于成功和失败的英语名言，仅供参考，希望对您有所帮助，感谢阅读。
1、勇敢的尝试是成功的一半。
A bold attempt is half success.2、谁笑到最后，谁就笑得最美。
He who laughs last laughs best.3、失败是一个事件，没有一个人。
Failure is an event, not a person.4、成功最大的阻碍就是害怕失败。
Successful one of the biggest obstacles is the fear of failure.5、只有经过黑夜，才能到达黎明。
Only through the night, to get to the dawn.6、永远不要把一次失败和最终失败。
Never put a failed and failed.7、再试试。
再次失败。
更好地失败。
Try again. Fail again. Fail better.8、迟做总比不做好；晚来总比不来强。
Better late than never. Late is better than not to come.9、失败只是更聪明地重新开始的机会。
Failure is the opportunity to begin again, more intelligently.10、为了更好的失败的变化，为更成功。
In order to better the change of failure, for more successful.11、有很多要说失败。
它比成功更有趣。
To say there are a lot of failure. It is more interesting than success.12、失败是犯了错误，但不能兑现的经验。
Failure is made a mistake, but fail to live up to experience.13、只要有一颗意志坚强的心，没事不成。
What Is Heart Disease
What Is Heart Disease?Bring up heart disease, and most people think of a heart attack. But there are many conditions that can undermine the heart's ability to do its job. These include coronary artery disease, cardiomyopathy, arrhythmia, and heart failure. Keep reading to find out what these disorders do to the body and how to recognize the warning signs.What Is a Heart Attack?Every year, more than 1 million Americans have a heart attack – a sudden interruption in the heart's blood supply. This happens when there is a blockage in the coronary arteries, the vessels that carry blood to the heart muscle. When blood flow is blocked, heart muscle can be damaged very quickly and die. Prompt emergency treatments have reduced the number of deaths from heart attacks in recent years.Heart Attack SymptomsA heart attack is an emergency even when symptoms are mild. Warning signs include:Pain or pressure in the chest.Discomfort spreading to the back, jaw, throat, or arm.Nausea, indigestion, or heartburn.Weakness, anxiety, or shortness of breath.Rapid or irregular heartbeats.Heart Attack Symptoms in WomenWomen don't always feel chest pain with a heart attack. Women are more likely than men to have heartburn, loss of appetite, tiredness or weakness, coughing, and heart flutters. These symptoms should not be ignored. The longer you postpone treatment, the more damage the heart may sustain.Signs of Coronary Artery DiseaseA precursor to a heart attack, coronary artery disease or CAD occurs when sticky plaque builds up inside the coronary arteries. This narrows the arteries, making it more difficult for blood to flow through. Many people don't know they have CAD until a heart attack strikes. But there are warning signs, such as recurring chest pain caused by the restricted blood flow. This pain is known as angina.Inside a Heart AttackThe plaque deposited in your arteries is hard on the outside and soft and mushy on the inside. Sometimes the hard outer shell cracks. When this happens, a blood clot forms around the plaque. If the clot completely blocks the artery, it cuts off the blood supply to a portion of the heart. Without immediate treatment, that part of the heart muscle could be damaged or destroyed.Don't Wait to Be SureThe best time to treat a heart attack is as soon as symptoms begin. Waiting to be sure can result in permanent heart damage or even death. If you think you may be having a heart attack, call 911. And don't try driving yourself to the hospital. When you call 911, the EMS staff can start emergency care as soon as they reach you.Sudden Cardiac DeathSudden cardiac death (SCD) accounts for half of all heart disease deaths in the U.S., but it's not the same as a heart attack. SCD occurs when the heart's electrical system goes haywire, causing it to beat irregularly and dangerously fast. The heart's pumping chambers may quiver instead of pumping blood out to the body. Without CPR and restoration of a regular heart rhythm, death can occur in minutes.Arrhythmia: Erratic Heart BeatRegular electrical impulses cause your heart to beat. But sometimes those impulses become erratic. The heart may race, slow down, or quiver. Arrhythmias are often harmless variations in rhythm that pass quickly. But some types make your heart less effective at pumping blood, and that can take a serious toll on the body. Let your doctor know if you've noticed your heart beating abnormally.CardiomyopathyCardiomyopathy is a disease involving changes in the heart muscle. These changes may interfere with the heart's ability to pump effectively, which can lead to a chronic condition called heart failure. Cardiomyopathy is sometimes associated with other chronic conditions, such as high blood pressure or heart valve disease.Heart FailureHeart failure doesn't mean your heart stops working. It means the heart can't pump enough blood to meet the body's needs. Over time, the heart gets bigger to hold more blood, it pumps faster to increase the amount of blood moving out of it, and the blood vessels narrow. The heart muscle may also weaken, reducing the blood supply even more. Most cases of heart failure are the result of coronary artery disease and heart attacks.Congenital Heart DefectA congenital heart defect is one that's present at birth. The problem could be a leaky heart valve, malformations in the walls that separate the heart chambers, or other heart problems. Some defects are not found until a person becomes an adult. Some need no treatment. Others require medicine or surgery. People with congenital heart defects may have a higher risk of developing complications such asTesting: Electrocardiogram (EKG)An EKG (also ECG) is a painless test that uses electrodes placed on the skin to record the heart's electrical activity. The test provides information about your heart rhythm and damage to the heart muscle. An EKG can help your doctor diagnose a heart attack and evaluate abnormalities such as an enlarged heart. The results can be compared to future EKGs to track changes in the condition of your heart.Testing: Stress TestThe stress test measures how your heart responds to exertion. If you have an exercise stress test, you'll either walk on a treadmill or ride a stationary bike while the level of difficulty increases. At the same time, your EKG, heart rate, and blood pressure will be monitored as your heart works harder. Doctors use a stress test to evaluate whether there is an adequate supply of blood to the heart muscle.Testing: Holter MonitorA Holter monitor is a portable heart rhythm recorder. If your doctor suspects a heart rhythm problem, she may ask you to wear one for 1 or 2 days. It records the heart's continuous electrical activity day and night, compared with an EKG, which is a snapshot in time. The doctor will probably also ask you to keep a log of your activities and to note any symptoms and when they occur.Testing: Chest X-rayA chest X-ray is a picture of your heart, lungs, and chest bones that's made by using a very small amount radiation. Chest X-rays can be used to look for heart and lung abnormalities.In this image, the bulge seen on the right side is an enlarged left ventricle, the heart's main pumping chamber.Testing: EchocardiogramAn echocardiogram uses sound waves (ultrasound) to generate moving images of the heart. The test can assess the chambers and valves of your heart and how well your heart muscle and heart valves are working. It's useful in diagnosing and evaluating several types of heart disease, as well as evaluating the effectiveness of treatments.Testing: Cardiac CTCardiac computerized tomography (known as cardiac CT) takes detailed images of the heart and its blood vessels. A computer stacks the images to create a 3-D picture of heart. A cardiac CT can be used to look for plaque or calcium buildup in the coronary arteries, heart valve problems, and other types of heart disease.Testing: Cardiac CatheterizationCardiac catheterization helps diagnose and treat some heart conditions. The doctor guides a narrow tube, called a catheter, through a blood vessel in your arm or leg until it reaches the coronary arteries. Dye is injected into each coronary artery, making them easy to see with an X-ray. This reveals the extent and severity of any blockages. Treatments such as angioplasty or stenting can be done during this procedure.Living With Heart DiseaseMost forms of heart disease are chronic. In the beginning, symptoms may be too mild to affect everyday life. And in many cases, long-term treatment can keep symptoms under control. But if the heart begins to fail, patients may develop shortness of breath, fatigue, or swelling in ankles, feet, legs, and abdomen. Heart failure can be managed with medication, lifestyle changes, surgery, and in certain cases, a heartTreatment: MedicinesMedications play a huge role in treating heart disease. Some drugs help lower blood pressure, heart rate, and cholesterol levels. Others can keep abnormal heart rhythms under control or prevent clotting. For patients who already have some heart damage, there are medications to improve the pumping ability of an injured heart.Treatment: AngioplastyAngioplasty is used to open a blocked heart artery and improve blood flow to the heart. The doctor inserts a thin catheter with a balloon on the end into the artery. When the balloon reaches the blockage, it is expanded, opening up the artery and improving blood flow. The doctor may also insert a small mesh tube, called a stent, to help keep the artery open after angioplasty.Treatment: Bypass SurgeryBypass surgery is another way to improve the heart's blood flow. It gives blood a new pathway when the coronary arteries have become too narrow or blocked. During the surgery, a blood vessel is first moved from one area of the body -- such as the chest, legs, or arms -- and attached to the blocked artery, allowing it to bypass the blocked part.Who's at Risk for Heart Disease?Men have a higher risk of having a heart attack than women, and at an earlier age. But it's important to note that heart disease is the No. 1 killer of women, too. People with a family history of heart ailments also have a higher risk of heart trouble.Risk Factors You Can ControlHigh cholesterol and high blood pressure are major risk factors for heart disease. Being overweight, obese, or physically inactive all increase your risk. So does diabetes, especially if your glucose levels are not well controlled. Discuss your risks with your doctor and develop a strategy for managing them. There are many steps you can take to protect your heart.Smoking and Your HeartIf you smoke, your risk of heart disease is 2 to 4 times greater than a nonsmoker's. And if you smoke around loved ones, you're increasing their risk with secondhand smoke. Each year in the U.S., more than 135,000 people die from smoking-related heart disease. But it's never too late to quit. Within 24 hours of quitting, your heart attack risk begins to fall.Life After a Heart AttackIt is possible to regain your health after a heart attack. By avoiding cigarettes, becoming more active, and watching what you eat, you can give your heart and overall health a big boost. One of the best ways to learn how to make these changes is to take part in a cardiac rehab program. Ask your doctor for recommendations.Heart Disease PreventionThe key to preventing heart disease is a healthy lifestyle. This includes a nutritious diet, at least 30 minutes of exercise most days of the week, not smoking, and controlling high blood pressure, cholesterol, and diabetes. If you drink alcohol, do so in moderation – no more than one drink a day for women, two drinks a day for men. Ask your friends and family for help in making these changes. They'll benefit, too.Diet and Your HeartWhat you eat makes a difference. Be sure you get plenty of whole grains, vegetables, legumes, and fruits to help keep your heart healthy. Plant oils, walnuts, other nuts, and seeds can also help improve cholesterol levels. And don't forget to eat fish at least a couple of times each week for a good source of heart-healthy protein.。
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阶段 D
难以管理的心力衰竭，需要特殊治疗 介入 (在静止下有明显心衰症状)
Refractory HF requiring specialized interventions (marked symptoms of HF at rest)
Hunt SA, et al. J Am Coll Cardiol. 2001;38:2101-2113.
7
18-Nov-2005
ACC/AHA 心衰阶段
ACC/AHA Stages of Heart Failure
心衰高危者
阶段 A
心衰高危但没有结构性心肌病或心衰 症状
At high risk of HF but without structural heart disease or HF symptoms
二级
轻微 静止时感到舒畅 中度运动会引起心衰症状
三级
▪ 明显 ▪ 静止时感到舒畅 ▪ 轻度运动会引起心衰症状
四级
▪ 严重 ▪ 静止时会有症状 ▪ 所有活动也会增加心衰症状
The Criteria Committee of the NYHA. Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Diagnosis. 6th ed. 1964.
2 18-Nov-2005
心衰是什么？
What is Heart Failure?
给心肌带来： - 负荷 - 创伤
因 结构性和功能性心肌失调
- 缺血性心肌病 (冠心病, 心肌梗塞) - 心肌炎 (病毒性, 美洲锥虫病) - 毒素 (酒精, 细胞毒性药) - 瓣膜病变 - 肺病 - 高血压 - 延续性心律失常
治疗心衰的目标
The Goal in treating Heart Failure
治疗心衰的目标： 1。 预防心肌重构 2。 逆传心肌重构
Goal: Prevent ventricular remodeling or reverse ventricular remodeling
100 75 50 25
神经激素反应
↓ MAP
交感神经系统
Sympathetic Nervous System
收缩力
血管缩窄
MAP = (SV x HR) x TPR
13 18-Nov-2005
自身调节/补偿机制
Compensatory Mechanisms
arling 机制
神经激素反应
肾素-血管紧张素系统
Frank-Starling 机制
神经激素反应
调节最初是适应性的，但继续性的补偿是有害的
Initially Adaptive, Deleterious if Sustained
反应
短期影响
长期影响
盐和水的保留
Salt and Water Retention
血管缩窄
Vasoconstriction
交感神经刺激
压力-容量环
Pressure Volume Loop
AVC Ejection AVO
One Cardiac Cycle
MVO
Filling
MVC
↑每搏输出量 (width of pressure volume loop) ↑每搏输作工 (area of pressure volume loop)
16 18-Nov-2005
形状
LVEDD LVEF
LVEDD 50mm LVEF 55%
LVEDD 65mm LVEF 40%
LVEDD 75mm LVEF 25%
15 18-Nov-2005
在心衰下心脏的变化/重构
How would the heart change/remodel under the influence of Heart Failure?
阶段 C
有心衰者
有结构性心肌病和 曾经或现在有心衰 症状
Structural heart disease with prior or current HF symptoms
阶段 B
有结构性心肌病但没有心衰迹象或症 状
Structural heart disease but without signs or symptoms of HF
增加新率和射血
Increases HR and ejection
导致泵衰竭恶化(后负荷的 增加), 增加心肌能量支出
Exacerbates pump dysfunction (excessive afterload), increases cardiac energy expenditure
增加能量支出
因
影响
结构性和功能性心肌失调 结构性和功能性心肌失调
- 缺血性心肌病 (冠心病, 心肌梗塞) - 心肌炎 (病毒性, 美洲锥虫病) - 毒素 (酒精, 细胞毒性药) - 瓣膜病变 - 肺病 - 高血压 - 延续性心律失常
- 缺血性心肌病 (冠心病, 心肌梗塞)
- 心肌炎 (病毒性, 美洲锥虫病)
- 毒素 (酒精, 细胞毒性药)
Sympathetic Stimulation
前负荷增加
Augments Preload
肺水肿，水肿(身体）
Pulmonary Congestion, Anasarca (body oedema)
保持血压以为持主要器官 所需的灌注
Maintains BP for perfusion of vital organs
影响 心室功能损失
- 缺血性心肌病 (冠心病, 心肌梗塞)
- 心肌炎 (病毒性, 美洲锥虫病)
- 毒素 (酒精, 细胞毒性药)
- 瓣膜病变
- 肺病
- 高血心压室充盈
-
延续性心律失常
Ventricular Filling
心室射血
Ejection
3 18-Nov-2005
心衰的种类
Types of Heart Failure
8 18-Nov-2005
ACC/AHA 心衰阶段 vs 纽约心功能分级
9 18-Nov-2005
心衰的恶性循环
Vicious Cycle of Heart Failure
左心室 功能受损
心脏负荷
(前负荷, 后负荷)
慢性病
一般来说
↓血液输出量
↓血压
血液输出量
(收缩能力增加，心率增加)
血压
(血管收缩，血液量增加)
影响心室 充盈
➢ 心室壁 僵硬 ➢ 舒张功能 受损
舒张性 功能损失
Diastolic Dysfunction
影响心室 射血
➢↑后负荷 ➢ 收缩功能 受损
Note:
心衰是一个 因结 构性或工能性心肌 失调 而影响心室 充盈和射血的复杂 临床疾病。
心肌收缩不同步 对充盈和射血的
影响？
收缩性 功能损失
Systolic Dysfunction
Renin-Angiotensin-Aldosterone ( renal perfusion)
盐和水的 保留
增强交感 神经系统
反应
血管缩窄
MAP = (SV x HR) x TPR
心输出量
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在心衰下心脏的变化/重构
How would the heart change/remodel under the influence of Heart Failure?
0 I
Survival
10
1
Hospitalization
.1
II
III
IV
左心室 功能受损
心脏负荷 (前负荷, 后负荷)
↓血液输出量 ↓血压
慢性病 一般来说
血液输出量
// (收缩能力增加，心率增加)
血压 (血管收缩，血液量增加)
自身调节/补偿机制
Frank-Starling 机制 神经激素反应
- 瓣膜病变
- 肺病 - 高血心压室充盈
- 延Ve续ntr性icu心lar律Fil失ling常
心室射血
Ejection
** ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult
自身调节/补偿机制
Frank-Starling 机制 神经激素反应
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自身调节/补偿机制
Compensatory Mechanisms
Frank-Starling 机制
神经激素反应
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自身调节/补偿机制
Compensatory Mechanisms
Increases energy expenditure
Jaski, B, MD: Basics of Heart Failure: A Problem Solving Approach
12
18-Nov-2005
自身调节/补偿机制
Compensatory Mechanisms
Frank-Starling 机制
1 Haldeman GA et al. Am Heart J. 1999; 137: 352 2 American Heart Association. Heart and Stroke Statistics. 2004 Update. 2003: 19
18
18-Nov-2005
心衰的住院率和生存率
心衰的诊断
Diagnostic of new onset of Heart Failure