高血压英文ppt精品课件pathways to heart failure in arterial

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1、InGeniousHyperCareIntegratinggenomics,clinicalresearchandcareinhypertensionGenetic,genomicsandproteomicsoftransitionfromhypertensiontoheartfailureExcellenceinphenotyping.CirculatingmarkersofLVgrowthanddysfunctionJRPB3IschemicheartdiseaseHHD=LVH±asymptomaticdysfunctionAorticvalvestenosisA

2、trialfibrillationPATHWAYSTOHEARTFAILUREINARTERIALHYPERTENSIONStageAHFStageBHFStageCHFHBP±otherriskfactors*HeartFailure[*DM,MetS,Ob…]Thethreemajorcausesofheartfailurearehypertensiveheartdisease(HHD),ischemicheartdiseaseassociatedwithpriormyocardialinfarction(s),andidiopathicdilatedcardiom

3、yopathy.Becausetheprevalenceofhypertensionisincreasingglobally,heartfailuresecondarytoHHDwillsoonbecomethemostcommoncauseofheartfailure.(BerkBCetal,JClinInvest2007;117:568-575)CLINICALANDEPIDEMIOLOGICALRELEVANCEOFHYPERTENSIVEHEARTDISEASEHHDwasoneofthe15leadingcausesofdeathandburdenofdise

4、asein2002.HHDisprojectedtomoveuptwoplaces(fromposition13thtoposition11th)intherankingfor2030(MathersCD&LoncarD,PlosMed2006;3:2011-2030)ThereisanimportantneedforphysicianstodetectHHD,understanditsmechanisms,andassessadequatelytreatmentoptionsavailableInthisconceptualframeworkthedevelopmen

5、tofbiomarkersforHHDcanbeofgreatinterestDEFINITIONANDCRITERIATOBEACCOMPLISHEDBYABIOMARKERAbiomarkerisacharacteristicthatisobjectivelymeasuredandevaluatedasanindicatorofnormalbiologicalprocesses,pathologicprocesses,orpharmacologicalresponsestoatherapeuticintervention(NIH,BiomarkersDefinito

6、nWorkingGroup,2001)Abiomarkermustaccomplishseveralcriteriarelatedtoitstechnicalmeasurementinblood.Feasiblemeasurement.Highlysensitiveandspecific.Abletobereproducedandstandardized.Withlowinherenterrorinthemeasurementrelatedtoitsbio-physiologicalsense.Changesinitsbloodlevelmustparallelchan

7、gesinitstissueexpressionandmustbeassociatedwiththeassessedprocessrelatedtoitsclinicalvalidity.Changesinitsbloodlevelmustreflectchangesinpatient’sclinicalstatus.Changesinitsbloodlevelmustreflectchangesinpatient’sprognosisSTEPSINTHEPROCESSOFDEVELOPMENTOFBIOMARKERSFORHYPERTE