1、Keep guideline in mind, walking your own way !Michael Fu, MD, PhD, FESCProfessor, Senior Consultant PhysicianHead, Heart Failure Center MedicineSahlgrenska University Hospital/SahlgrenskaGteborg, SWEDENHow to optimize heart failure management ?Chronic Heart FailureMore common than we believe !2 %10
2、% CHF: A aged population01002003004005006007001960 1980 2000 2020Millions165296403649Chronic Heart Failure A disease state which seldom stops !Risk factors:diabeteshypertensionVascular dysfunctionVascular diseaseTissue injury(MI, stroke) PathologicalremodelingTarget organ dysfunction (HF, renal)Symp
3、atikusAngiotensin IIaldosterone-The Cardiovascular ContinuumAdapted 2003 from Dzau V, Braunwald E. Am Heart J. 1991; Gibbons 1999.Heart failureDeathChronic Heart Failure More malignant than we believe !CHF: More malignant than most cancer !Stewart et al. Eur J Heart Failure 2001, 3(3): 315-ARisk fac
4、torIschemeaHypertentionDiabetesBHeart dysfunctionCHeart failureDRefractory HFStandard Heart failure careExtraordinary measureRisk modificationXXChronic Heart FailureWorse than we believe in CHF treatmentdiureticdigoxindiureticdigoxindiureticdigoxinACE-IdiureticdigoxinACE-IdiureticdigoxinACE-I blockerdiureticdigoxinACE-I blockerACEI (1991) blocker (1999) ARB (2003) ACE-I blockerARBEvidence-based heart failure medicationsOne yearmortality(%)
