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[慢性心力衰竭的病理生理学、病因及流行病学]

[Pathophysiology, causes and epidemiology of chronic heart failure].

作者信息

Špinar Jindřich, Špinarová Lenka, Vítovec Jiří

出版信息

Vnitr Lek. 2018 Fall;64(9):834-838.

Abstract

The prevalence of heart failure in developed countries is about 1-2 % in general and in patients above 70 years over 10 %. HFpEF is the cause of heart failure from 22 to 73 %, exact data are not available. If compared with HFrEF, patients with HFpEF are older, more frequent women with hypertension and atrial fibrillation, but less myocardial infarction in their history. Heart failure is a hemodynamic disorder and the pathophysiologic basis is cardiac output, cardiac contractility, filling pressures, wall stress during systolic and diastolic function and heart rate. The neurohumoral activation is very important for the diagnosis as well as prognosis and the most sensitive seems to be brain natriuretic peptide (BNP), respectively the precursor NT-proBNP, which become a part of the new diagnostic classification and are a part of modern treatment. Key words: heart failure - hemodynamics - neurohumoral activation.

摘要

在发达国家,心力衰竭的总体患病率约为1%-2%,70岁以上患者的患病率超过10%。射血分数保留的心力衰竭(HFpEF)导致心力衰竭的比例为22%至73%,尚无确切数据。与射血分数降低的心力衰竭(HFrEF)相比,HFpEF患者年龄更大,女性更多,常伴有高血压和心房颤动,但既往心肌梗死病史较少。心力衰竭是一种血流动力学紊乱,病理生理基础是心输出量、心脏收缩力、充盈压、收缩期和舒张期功能时的壁应力以及心率。神经体液激活对诊断和预后都非常重要,最敏感的似乎是脑钠肽(BNP),即前体N末端脑钠肽原(NT-proBNP),它们已成为新诊断分类的一部分,也是现代治疗的一部分。关键词:心力衰竭-血流动力学-神经体液激活

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