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HeartFailureHeartFailure心衰心衰approx.100,000heartbeats/dayapprox.2,760,000,000heartbeats/lifetimeapprox.4,000gallons(15,000liters)bloodpumped/dayappox，3，832，500，000liters/lifetime小型水库＜1000m3中型水库＞1000m3大型水库＞100,000000m3龙泉驿水库蓄水约330万立方米Concept概念Pathogenesis发病机制Effect（important）andmechanisms影响及机制Outline大纲Background背景Definitionandexplainingthedefinition定义pathogenesis机制Content内容心为君主之官，脏腑百骸，惟所是命，聪明智慧，莫不由之"Theheartismoredeceitfulthananything.Itisincurable—whocanknowit?Jeremiah17:9-10Heartfailure心衰----BackgroundHeartfailure心衰----BackgroundCatslookdownonus.Dogslookuptous.PigstreatusasequalsHeartfailure心衰----BackgroundWhatkillus?Background《2010年中国心血管病报告》1/5adultssufferfromcardiovasculardisease3milliondiefromcardiovasculardiseaseaccountfor41%ofdeathnumberChinadeath1/11.6sAmericadeath1/34.0sequivalenttoonceWenchuanbigearthquakeBackground《thereportofcardiovasculardiseaseinchina2010》hypertension高血压2亿人myocardialinfarction心肌梗200万人pulmonaryheartdisease肺心病500万人rheumaticheartdisease风心病250万人congenitalheartdisease先心病200万人heartfailure心衰竭420万人《2010年中国心血管病报告》《thereportofcardiovasculardiseaseinchina2010》BackgroundWeFaceanepidemicofHFAffecting0.4-2%oftotalpopulation，8-10%ofelderlyTheglobalHFpatientshaveupto2250million，increasingat200millionperyearTheprognosisofHFsimilartocancerorevenworseThe20%patientswithHFreadmissionafterdischargedfromhospitalin30daysLessthan50%patientssurvival5yearsfromthediagnosisofheartfailureAveragesurvivaltimeis16month，inhospitalonly25%survival5yearsBackground020406080100HeartdiseaseCerebrovascularmalignancyaccidentalrespiratorygastrointestinalcommunicableUrinarysystemNeuropsychosisEndocrinosisLifestyleBiogenticsEnvironmentalfactorsHealthcareTop10causeofdeathinChinaandthemainriskfactors%ForecastingthefutureofcardiovasculardiseaseintheUnitedStatesCirculation2011;123(8):933-944EstimateddirectandindirectcostofmajorcordialdiseaseInunitedstatein2010TheEconomicBurdenOfCardiovascularDiseasesCoronaryheartdiseaseHypertensivediseaseStrokeHeartfailure$53.9$34.4Costinbillion$105.9$93.5Clinicalintervention生死LowriskstateDangerousstateEarlychangeDifferentprognosisClinicdiseaseSub-clinicsymptomsPreventinterventionHypertensionhyperlipidmiasmokingdiabetesobeyhereditarypsychologicalinterventionNationalstandardlifestyledrugoperationphysicsBackgroundheathsub-healthsub-clinicdiseaseRiskFactorsEndothelialDysfunctionAtherosclerosisCoronaryarterydiseaseMyocardialIschemiaCoronaryThrombosisMyocardialInfarctionArrhythmia&LossofMuscleRemodelingVentricularDilationCongestiveHeartFailureEndstageHeartDiseaseTheProgressiveDevelopmentofChronicCardiovascularDisease慢性心血管疾病渐进式发展心功不全insufficiencyHeartfunctionPhysicalActivitylimitationSymptomsatrestDescriptionINonoalmostasnormalpersonIIMildSlightnoCanwithstandheavierphysicalactivityIIImoderateobviousnoCanwithlighterphysicalactivityIVsevereobviousyesLoselaborabilitycompletelyLife-threating分级:TheNewYorkHeartAssociationFunctionalClass(NYHA-FC)心肌收缩力因各种①病因减弱（原发或继发），不能将静脉回心血量等量搏出，因而使②心输出量绝对或相对减少，③使体循环和/或肺循环静脉系统淤血，动脉系统供血不足，不能满足人体在静息状态或一般活动时代谢的的需要，从而出现一系列的心脏循环障碍的④症状和体征...