《舒张性心力衰竭》课件.pptVIP

Clinical Aspects of Diastolic Heart Failure Shin-ichi Momomura, MD Cardiovascular Center Toranomon Hospital Tokyo, Japan Incidence of Heart Failure Framingham Heart Study Distribution of Left Ventricular Ejection Fraction: EuroHeart Failure Survey What is Diastolic Heart Failure? Diastolic (Heart) Failure Heart failure due to diastolic dysfunction Heart Failure with Preserved or Normal　Systolic Function Cf) Systolic Heart Failure Causes of Diastolic Dysfunction Left ventricular hypertrophy (common) Aortic stenosis Chronic hypertension Hypertrophic cardiomyopathy (with/wothout outflow tract obstruction) Acute episodic myocardial ischemica (common) Pericardial disease (rare) Tamponade Constriction Constrictive-effusive disease due to prior radiation therapy Restrictive cardiomyopathy (rare) Amyloid disease Idiopathic restrictive cardiomyopathy Mechanism of DHF Epidemiology of DHF Prevalence of DHF Distribution of the severity of left ventricular systolicdysfunction by qualitative assessment Prognosis of DHF and SHF (2) Characteristics: Demographic Characteristics: Cardiac History Characteristics: Cardiac History Characteristics: Non-cardiac History DHF in Japan DHF in Japan DHF in Japan DHF in Japan：Mortality and Readmission Chronic Heart Failure Analysis Registryin Tohoku District (CHART) Diagnosis of DHF Sign and symptoms of heart failure Non-cardiac disease are excluded Normal or preserved LV contraction Documented diastolic dysfunction Elevated plasma BNP Evaluation of LV diastolic function Indexes of isovolumic relaxation Peak negative dP/dt, Time constant (Tau) IRT Indexes of passive distensibility Stiffness constant of diastolic PV relation End-diastolic P/V ratio Indexes of LV filling Peak filling rate, Deceleration time, E, E/A Indexes of LV isovolumic relaxation Doppler Criteria for Classification of Diastolic Function Participants BNP levels in patients with normal function and with diastolic dyfunction BNP values and three diastolic patterns Treatme