心力衰竭器械治疗的研究进展

综述心力衰竭器械治疗的进展。心力衰竭病人较多,是所有心血管疾病的最后共同归路,尽管在心力衰竭的药物治疗方面取得了重大进展,但心力衰竭相关的发病率和死亡率依然很高。器械治疗是心力衰竭尤其是严重心力衰竭病人的重要治疗方式。近年来,器械治疗的不断进展使更多心力衰竭病人受益,主要包括心脏除颤器械、心脏收缩力调节器、压力激活治疗、传导系统起搏。     

中医药治疗心力衰竭的临床研究新进展

心力衰竭是心脏病的终末阶段,近些年来中医药在治疗心力衰竭方面积累了丰富经验,现对近10年中医药治疗心力衰竭的经方、成药、辨证、协定方的临床研究进展进行综述,为中医药治疗心力衰竭提供参考依据。     

急性心力衰竭诊断和治疗展望

心力衰竭作为心血管事件链的下游是21世纪心血管疾病治疗的最后战场,急性心力衰竭常危及生命,必须紧急施救和治疗。N端-脑钠肽前体是鉴别急性心力衰竭与其他原因所致呼吸困难的重要指标,和超敏C反应蛋白、肌钙蛋白与急性心力衰竭的程度、预后密切相关。奈西立肽、左西孟旦、托伐普坦、rolofylline等为急性心力衰竭的药物治疗带来前景,急性心力衰竭的非药物治疗将成为药物治疗的有效伴随手段。全方位多层次的防治是降低急性心力衰竭再住院率、病死率的重要方式。     

中西医结合治疗心力衰竭伴大量胸腔积液1例体会

通过对心力衰竭的中医病因病机的探讨及用于治疗心力衰竭的中药现代药理特点研究,证实中医中药治疗心力衰竭的可行性及特殊优越性,为治疗难治性心力衰竭特别是利尿剂抵抗型心力衰竭提供经验。     

利尿剂治疗心力衰竭的研究现状

心力衰竭是各种心血管疾病的终末阶段,主要表现为呼吸困难、体力活动受限和体液潴留。在心力衰竭治疗的药物中,利尿剂是唯一能够缓解患者水钠潴留的药物,是心力衰竭治疗中必不可少的组成部分,合理使用利尿剂是心力衰竭治疗取得成功的关键因素。     

心房内分流术治疗慢性心力衰竭的进展

尽管抗心力衰竭药物治疗和器械治疗有了长足的发展,但射血分数降低的心力衰竭或射血分数保留的心力衰竭发病率和死亡率仍居高不下。即使经过充分的抗心力衰竭药物治疗,仍有近50%的心力衰竭患者临床心功能得不到明显改善。射血分数保留的心力衰竭临床特征是劳力性呼吸困难,通常在运动时左心房压力异常升高所致。人为建立心房内分流减轻左心房负荷可能是一种新的治疗方法。现将心房内分流术治疗慢性心力衰竭尤其是射血分数保留的心力衰竭的最新进展进行综述。     

沙库巴曲缬沙坦治疗心力衰竭的作用机制、临床应用及指南推荐意见

心力衰竭是多数心血管疾病的归宿,已对全人类身心健康及生命安全构成严重威胁。血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂、β-受体阻滞剂及醛固酮受体拮抗剂是有效治疗心力衰竭的"金三角",虽然在过去的20年内心力衰竭治疗方面取得了长足进步,但心力衰竭患者5年病死率仍高达50%。沙库巴曲缬沙坦属血管紧张素受体-脑啡肽酶抑制剂,是一种新型心力衰竭治疗药物,并有望成为治疗心力衰竭的"基石"。本文对沙库巴曲缬沙坦治疗心力衰竭的作用机制、临床应用及指南推荐意见进行了综述,旨在提高临床对该药的认识及心力衰竭治疗水平。     

心脏再同步治疗除颤器在心力衰竭患者的疗效观察

慢性心力衰竭是各种心血管疾病（包括缺血性心肌病、扩张性心肌病等）的一种转归,也是心血管疾病的主要死亡原因之一。虽然心力衰竭的药物治疗不断取得进展,但仍有部分顽固性心力衰竭疗效不佳。心脏再同步治疗（CRT）以及心脏再同步治疗除颤器（CRT—D）治疗顽固性心力衰竭的疗效近年来已经得到公认。本文就本院植入CRT—D治疗顽固性心力衰竭患者的资料进行回顾性分析并总结。     

硝普钠和多巴胺合用治疗难治性心力衰竭疗效观察

难治性心力衰竭系指经正规的心力衰竭治疗（包括病因、诱因和对症治疗）后,治疗反应差、症状持续的充血性心力衰竭。其预后差。治疗一直是临床上很棘手的问题。笔者所在科采用硝普钠、多巴胺合用治疗难治性心力衰竭取得了较好的疗效,现简报如下。     

依那普利联合螺内酯治疗老年心力衰竭的远期临床疗效

尽管医疗条件不断改善以及心血管疾病治疗水平逐步提高,但由于人口老龄化,老年心力衰竭的发病率仍逐年增加,常规的心力衰竭治疗虽可改善血流动力学变化,但远期疗效不佳。心力衰竭的治疗目标不仅仅是改善症状、提高生活质量,更重要的是防止和延缓心肌重塑的发展,从而减少心血管事件,降低心力衰竭的病死率和住院率,改善长期预后。本研究对老年心力衰竭患者应用依那普利和螺内酯联合药物治疗,观察远期临床疗效,在老年心力衰竭患者的治疗上进行研究探讨。     

心力衰竭治疗药物的新变革—沙库巴曲缬沙坦

心力衰竭是一项极其重要的危害人类健康的全球性公共卫生问题,是心血管疾病发生发展的终末阶段,其发病率、再住院率及死亡率在逐年不断的增长,这使得进一步开发更为有效的新型心力衰竭治疗药物迫在眉睫,而具有血管紧张素受体脑啡肽酶抑制剂双重作用机制的沙库巴曲缬沙坦的上市为心衰患者的治疗带来了新的变革。     

犬心衰动物模型制作现况及进展

心力衰竭是心脏泵血功能衰竭，无法将静脉回流的血液充分泵出以满足全身组织代谢需求的一种病理生理状态及临床综合征。随着老龄化、不健康饮食习惯等危险因素的积累，心力衰竭的发病率逐年增加并对人类健康产生严重威胁。动物模型可间接模拟人体心衰的发生、发展、治疗的过程，但是并不能完全展示心衰整个发展过程及治疗效果。所以选择合适的心衰模型对实验至关重要。本文将对心衰模型的制作方法，适应症及优缺点选择进行综述。     

Epidemiology of heart insufficiency

The epidemiology of congestive heart failure is not well known in France, despite its dramatic economic impact on the health care system. The number of patients with congestive heart failure is about 500,000 with 120,000 new cases per year. The incidence ranges from 4@1000 in men and 3@1000 in women 55-64 years old to 50@1000 in men and 85@1000 in women 85-94 years old. Mean age at onset is 73.5 years, and two thirds of the patients are older than 70 years of age. There are about 3,500,000 outpatient visits and 150,000 hospitalizations for congestive heart failure every year. It is responsible for more than 32,000 deaths every year. Costs of congestive heart failure represent more than 1% of the total medical costs. It represents a major and growing public health burden. This should encourage us to optimize its medical treatment and prevention.     

影响射血分数保留的心力衰竭相关疾病及心功能障碍的机制研究进展

射血分数保留的心力衰竭（HFpEF）是一种严重威胁人类健康且机制复杂的临床综合征,约占全部心力衰竭总数的一半。其发病率伴随着人口老龄化的发展而逐年上升,病死率与射血分数减少的心力衰竭（HFrEF）相当,传统的药物治疗虽能降低HFrEF患者的再住院率及死亡率,却不能有效的改善HFpEF患者的预后。目前,对HFpEF的发病机制、诊断、治疗等许多方面尚无统一的认识,加之临床医师对HFpEF的认识存在局限性,均使得HFpEF成为心血管防治领域的社会公共难题及主要挑战。为了解国内外射血分数保留的心力衰竭的病理机制及诊疗情况,现从其影响其的相关疾病、病理机制、诊断治疗等方面进行综述。     

Heart failure: a growing public health problem

Abstract. At a time when deaths from coronary heart disease and stroke are markedly declining, mortality from heart failure is increasing. Heart failure is a costly and devastating disease, and throughout much of the industrialized world, escalating health-care costs constitute a serious burden on both public and private systems of financing health care, and about one-third of all heart failure patients are admitted to hospital each year. Both prevalence and incidence of heart failure increase steeply with increasing age. The prevalence rate is about 1% at the age of 50, whilst at the age of 80 and above, almost one out of 10 persons will suffer from heart failure. Until recently, the goals for heart failure treatment were to relieve symptoms and enhance functional capacity. Recently, some large scale studies have shown that ACE inhibitors can reduce mortality, prevent development of heart failure, avoid the need for hospitalization and improve prognosis. ACE inhibitors may therefore have promising effects both on patients and on society. A challenge for the future must be early recognition and timely and adequate treatment of heart failure. Such a strategy might have great economic benefits as far as public health is concerned. However, the most rewarding efforts for the population will be to prevent the underlying causes of coronary heart failure as well as risk factors for heart failure. This review will study the magnitude of heart failure as a growing public health problem, the underlying causes, risk factors and treatment.     

急性心力衰竭综合征诊疗新进展

急性心力衰竭综合征发生率逐年增多且预后不良,严重威胁人类健康.临床上虽极受重视,但一直缺乏有说服力的循证医学研究证据.近年来开展的一些大系列登记研究发现,急性心力衰竭综合征在流行病学、预后及治疗上与经典观念有很大差别.现对此做一简单阐述,并就一些新的相关观念作简单介绍.     

Alternative therapies for orthotopic heart transplantation

Heart failure has reached epidemic proportions in the United States. More than 5 million patients are treated for heart failure and approximately a half a million new patients are diagnosed with this disease each year in the United States. Recent pharmacological therapies have been used for the treatment of this patient population, but heart failure remains a major source of morbidity and mortality for patients. Orthotopic heart transplantation is a viable treatment option for heart failure patients; however, cardiac transplantation is limited by the donor availability. Limited donor organ availability has led to the development of alternative therapeutic strategies, including xenotransplantation, mechanical support devices, and cell transfer/tissue engineering protocols. This review highlights the current treatment modalities and emerging strategies for the treatment of advanced heart failure.     

Are angiotensin-converting enzyme inhibitors and β-blockers making an impact on the epidemiology of heart failure?

With the advent of the 21st century, heart failure has emerged as a major component of the massive public health problem of cardiovascular disease. Currently over 5 million Americans suffer from the syndrome of heart failure with significant direct treatment costs estimated to be in excess of $22 billion per year. Unfortunately, assuming present demographic and medical trends continue, these bleak statistics are expected to worsen substantially over the next two decades. Epidemiologic studies have furthered our mechanistic understanding of heart failure pathophysiology by demonstrating that many patients with this syndrome have preserved systolic function by standard indices. In a positive turn, major advances have occurred in the treatment of heart failure based on the development of clinically effective pharmacologic antagonists of the renin-angiotensin-aldosterone and sympathetic nervous systems. These agents are capable of substantially reducing the morbidity and mortality associated with heart failure. However, the importance of enhanced physician and public awareness of heart failure remains critical in the future.     

心力衰竭靶向治疗的研究进展

心血管疾病是严重威胁我国居民健康的主要疾患之一,致死率长期居于我国疾病谱首位。随着人口老龄化的飞速进展,心血管疾病患病率和死亡率仍有上升趋势,然而,目前心力衰竭的治疗效果及预后并不理想,故探究心力衰竭潜在的致病机制并挖掘新的治疗靶点尤为重要。该综述就近年来心力衰竭靶向治疗的研究进展进行综述,为延缓心力衰竭的进程提供新的思路。     

心肌梗死后左室重构发病机制进展

急性心肌梗死(AMI)是威胁人类健康的重大疾病,心肌梗死(MI)后30 min,部分心肌细胞即发生不可逆的坏死,因此,MI有效救治的时间窗极为短暂,许多患者不能够得到及时有效的治疗,使得MI后心力衰竭(HF)的发生率仍然居高不下。最新调查研究表明,MI后1年HF的发生率约为14.2%。因MI后HF再次入院的患者,1年死亡率高达为45.5%。MI后HF的主要原因是部分心肌细胞坏死,左室重构,心脏扩张,继而引发HF。目前,MI后左室重构的机制尚未完全阐明。本文介绍了AMI后左室重构的发病机制主要进展。