HF 诊断和治疗治疗指南-严晓伟译.ppt

Following the diagnosis and if possible the underlying causes of chronic heart failure, the treatment aims at: - preventing: - the progression of heart failure or controlling the diseases which will lead to cardiac dysfunction and therefore heart failure. The prevention of heart failure should always be a primary objective. - the progression of heart failure itself - Maintaining or improving the quality of life, consisting mostly of the management of symptoms. - Increase the duration of life. Nonpharmacological treatments and lifestyle modifications have only been adequately tested as adjuvant strategies to pharmacological therapy. However, they should be considered as part of the basic treatment of heart failure. They consist of: - Educating the patients and their close relatives on the pathology (how heart failure occurs, what the causes are, how it will affect their life). - Patients are advised to weigh themselves on a regular basis and in case of sudden unexpected weight gain, to alert the health care provider or modify their diuretic intake if they are familiar with it. - The respect of the dietary measures is of an utmost importance, to avoid direct degradation of the heart failure as well as preventing other cardiovascular damage. - Smoking should of course always be discouraged. The use of smoking cessation aids should be actively discouraged, and may include nicotine replacement therapies. - Finally, rest and exercise training should be cautiously adapted to the patient’s condition. Pharmacological treatment of chronic heart failure consists of the following therapeutic classes: - ACE inhibitors - ?-Blockers - Diuretics - Angiotensin II antagonist receptors (AIIA) - Others ACE inhibitors are, and remain more than ever, the cornerstone of the treatment of heart failure, as they are recommended first-line. There is a wealth of evidence that ACEI improve symptoms and mortality in patients with heart failure. To date,