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射血分数保留的心力衰竭

[Heart failure with preserved ejection fraction].

作者信息

Špinar Jindřich, Vítovec Jiří, Špinarová Lenka

出版信息

Vnitr Lek. 2016 Fall;62(7-8):646-51.

Abstract

UNLABELLED

Heart failure with preserved ejection fraction occurs almost with the same frequency as heart failure with reduced ejection fraction. The diagnosis is based on echocardiography with evidence-based ejection fraction over 50 %, or with left atrial enlargement and left ventricular hypertrophy, and specification of natriuretic peptides. BNP 35 pg/ml and NT-proBNP 125 pg/ml are considered the limits of the norm for chronic heart failure. The treatment of heart failure with preserved ejection fraction lacks clear evidence of mortality reduction, diuretics are recommended to remove symptoms, ACE inhibitors or sartans and beta-blockers to improve the prognosis. Anticoagulation treatment is recommended for atrial fibrillation and possibly digoxin, hypolipidemics for patients in secondary prevention. An important goal of the treatment is the control of accompanying diseases such as hypertension, diabetes mellitus and ischemic heart disease.

KEY WORDS

accompanying diseases - treatment - heart failure - heart failure with preserved ejection fraction.

摘要

未标注

射血分数保留的心力衰竭发生频率几乎与射血分数降低的心力衰竭相同。诊断基于超声心动图,证据为射血分数超过50%,或伴有左心房扩大和左心室肥厚,以及利钠肽的测定。慢性心力衰竭的正常范围界限为BNP 35 pg/ml和NT-proBNP 125 pg/ml。射血分数保留的心力衰竭治疗缺乏降低死亡率的明确证据,推荐使用利尿剂消除症状,使用ACE抑制剂或沙坦类药物以及β受体阻滞剂改善预后。对于心房颤动推荐抗凝治疗,可能还需使用地高辛,二级预防的患者需使用降血脂药物。治疗的一个重要目标是控制伴发疾病,如高血压、糖尿病和缺血性心脏病。

关键词

伴发疾病 - 治疗 - 心力衰竭 - 射血分数保留的心力衰竭

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