pensate heart failure
Frank-Starling principle neurohumoral activation myocardial hypertrophy
pensate heart failure
①cardiac dilatation, by way of the FrankStarling principle ,contractile force increases.
Fundamental causes
2.increased burdens to the heart
②increased preload (volume load):
A. mitral incompetence B. aortic incompetence C. tricuspid incompetence D. atrial septal defect (ASD) E. ventricular septal defect (VSD) F. patent ductus arteriosus(PDA) G. hyperthyroidism H. anemia
Evaluation of chronic HF cardiac function
Fundamental causes
1. primary myocardial disease 2. ased burdens to the heart
Fundamental causes
1. primary decreased myocardial contractility
ClassⅢ Marked limitation of physical activity Less than ordinary activity causes symptoms Asymptomatic at rest
ClassⅣ Inability to carry out any physical activity without discomfort Sympotoms at rest
New York Heart Association Functional Classification
ClassⅠ No limitation of physical activity No sympotoms with ordinary exertion
ClassⅡ Slight limitation of physical activity Ordinary activity causes symptoms
A. coronary heart disease B. myocarditis ,cardiomyopathy C. myocardial metabolic disorder
Fundamental causes
2. increased burdens to the heart
①increased afterload (pressure load): A. hypertension B. aortic stenosis C. pulmonary stenosis D. pulmonary hypertension
Categories of HF
1. left, right and whole 2. acute and chronic 3. systolic and diastolic
stage of HF
A. Pre-heart failure B. Pre-clincal heart failure C. Clinical heart failure D. Refractory end-stage heart failure
excessive salt taking E. malpratice F. primary disease deterioration
or a new disease happens
Pathogenesis and pathophysiology
pensate heart failure 2. Ventricular remodeling 3.About diastolic insufficiency 4. Humoral factors change
Precipitating causes
A. infection ,especially respiratory infection B. arrhythmias,AF C. physical or emotional excesses
e.g. pregnancy and delivery D. rapid intravenous infusion ,
Stage and Class of HF
• 心衰分期是NYHA分级的补充，但不能替代 NYHA分级
• NYHA分级 – 在具体病人可上下变动 (对治疗的反应和/或疾病进程不同)
• 分期 – 随心脏重构加重只能进展
6-min walk distance
mild degree： ＞450m moderate degree： 150-450m severe degree： ＜150m
Heart Failure (HF)
Heart failure (HF)
Conception : heart failure is a final common pathway for many cardiac disorders of diverse etiology and pathogenic mechanisms. It is a clinical syndrome, manifested as a result of the inability of the heart to match its output to the metabolic needs of the body even though the filling pressure of the heart is adequate.