资源描述：
《如何避免慢性心力衰竭恶化》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、TohruIzumi,ToshimiKoitabashi,MototsuguNishii,TakayukiInomataDepartmentofCardio-Angiology,KitasatoUniversitySchoolofMedicine,Sagamihara288-8555,JapanOct23rd,2008,Beijing,HowtoPreventFromWorseningofChronicHeartFailureThe4thChina-JapanCardiovascularForum(CJCF)Chroni
2、cHeartFailureand DiseaseBurdenBurdenAgingCVEventCVEventBNPguidedtherapyforCHFpatientReductionofcardiacevent(diseaseburden)Indicator:BNPCHFACEI+BBTxComprehensivemanagementDiuretics０ １８ ４０ １００ ２００ ５００ pg/mLＢＮＰscale*PlasmaBNPlevelistitratedbyRIAusingShiono
3、ria(Shionogi,Osaka)Afterdischargewith/withoutBNPguidedFollowupperiodafterdischarge(days)1.00.60.800.20.40200400600Cardiac-event-freesurvivalClinicalguidedTxBNPguidedTxp=0.0435readmissionrate365days16.6%31.5%・Intwoyearsfollow-up,thereweresignificantlylowercardiace
4、vents,readmission,inBNPguidedTxincomparisonwiththeclinicalguidedTx.Cumulativerateoftheeventwithinoneyearreducedfrom31.5to16.6%.InomataT,etal.JpnCircJ2001;65(S-1A),282.GroupIGroupIISRSRAfAfKoitabashiT,InomataT,etal.ESC2004BNPguidedTxcancelledoutprognosticcontribut
5、ionbyAFinCHFmanagementAlteredprognosisofAfPtsbyintroducingBNPguidedTxHF-event-freesurvival(%)GroupIIBNPguidedera(‘00-02)GroupIClinguidedera(‘96-98)SRgroupAfgroupFollow-upperiod(month)<200pg/mL≥200pg/mLEventfreesurvival0.00.10.20.30.40.50.60.70.80.91.0010203040506
6、0708090Follow-upperiod(months)Eventfreesurvival0.00.10.20.30.40.50.60.70.80.91.00102030405060708090Follow-upperiod(months)P<0.0001TotaldeathArrhythmiceventsBNP<100pg/ml,n=213BNP≧100pg/ml,n=176P=0.0028BNP<100pg/ml,n=213BNP≧100pg/ml,n=176BNPandArrhythmicPrognosisKI
7、TASATOUNIVERSITYCost-effectivenessofBNPgTxQALY(qualityadjustedlifeyear)YearsCosts＄＊＊＊MorimotoT,IzumiT,FukuiTetal,IntJCardiol, 2004ClinicalIndicatorCheckPointforCHFManagementDry+WarmBNP<200NewIndex?HospitalizationLethal/DisabilityTherapeuticplanFundamentalTXAdjunc
8、tiveTXReinforceTXDefaultLVAD/HTXTotalBililbinCare/HospiceRemodelingvs.ReverseRemodelingCardiacResynchronizationTherapy(CRT)vs.ReverseRemodelingBeforeCRTTwoweek
