舒张性心力衰竭治疗进展

综述了舒张性心力衰竭诊断与治疗的新进展。诊断应具备三个条件 :充血性心力衰竭的症状和体征 ;正常或仅轻度损害的收缩功能 ;有左室松弛、充盈、舒张性扩张或僵硬度异常的证据。治疗应注重原发病的治疗 ,β 受体阻滞剂、ACE抑制剂、钙离子拮抗剂均可应用 ,在合并收缩功能不全或合并房颤时才使用洋地黄。应用利尿剂可降低肺静脉压 ,但舒张性心力衰竭是容量敏感的 ,过量利尿可导致心输出量的减少。

Progress in Treatment ofDiastolic Heart Failure

The article reviews the current progress in diagnosis and treatment of primary diastolic heart failure.There are three obligatory conditions should be simultaneously satisfied to make diagnosis:(1)Presence of the signs or symptoms of congestive heart failure;(2)Presence of normal or only mildly abnormal left ventricular systolic function;(3)Evidence of abnormal left ventricular relaxation or filling,diastolic distensibility and diastolic stiffness.Treatment should be initially directed towards improving primary cardiac disorders.β-blocker,ACE inhibitor,calcium channel antagonist can be used.Digoxin is not used unless diastolic heart failure is accompanied by systolic heart failure and atrial fibrillation.Loop diuretics can be use to relieve the symptoms of pulmonary congestion,but over-diuresis may result in the decrease of cardiac output。