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1、HeartFailure withPreservedLVEFHFSA2010RecommendationsHFSA2010PracticeGuidelinePreservedLVEF—DiagnosisRecommendation11.1CarefulattentiontodifferentialdiagnosisisrecommendedinpatientswithHFandpreservedLVEFtodistinguishamongavarietyofcardiacdisorders,becausetreatmentsmaydiffer.Thesevario
2、usentitiesmaybedistinguishedbasedon:EchocardiographyElectrocardiographyStressimaging(viaexerciseorpharmacologicmeans,usingmyocardialperfusionorechocardiographicimaging).CardiaccatheterizationStrengthofEvidence=CFigure11.1.DiagnosticCriteria: HFwithReducedvs.HFwithPreservedEFClinicalev
3、idenceofHF:ClearclinicalpresentationofHForFraminghamorBostoncriteriaIfuncertain:PlasmaBNPorchestx-rayorcardiopulmonaryexercisetestingLVEF<50%LVEF≥50%Supportiveevidence:EccentricLVHorremodelingSupportiveevidence:ConcentricLVHorremodelingLeftatrialenlargementinabsenceofAFEchoDopplerorca
4、theterevidenceofdiastolicdysfunctionExclusions:Non-myocardialdiseaseExclusions:Non-myocardialdiseaseAdaptedfromYturraldeFR.ProgCardiovascDis2005;47:314-19HFwithReducedEFNon-MyocardialaHighoutputAnemia,AVfistulaValvulardiseaseAS,AR,MR,MSMyocardialbHypertensionCADDiabetesInfiltrativemyo
5、pathycCardiomyopathygenetic,post-partum,viral,drug/radiationHFwithPreservedEFNon-MyocardialaHighoutputAnemia,AVfistulaValvulardiseaseAS,AR,MR,MSMyocardialbHypertensionCADDiabetesCardiomyopathygenetic,post-partum,viral,drug/radiationInfiltrativemyopathycPericardialconstraintconstrictio
6、n,tamponadeFigure11.2.EtiologyofHFwithReducedvs.HFwithPreservedLVEFa=causeofHForspecifictargetfortherapyb=diseaseprocessthatmayleadtoHFc=mayhavestageinwhichEFisnormal,butoftendeclinesFigure11.3.DiagnosticAlgorithm forHFwithPreservedLVEFHFwithPreservedLVEFDilatedLVNon-dilatedLVValvular
7、diseaseAR,MRNovalvulardis.HighoutputHFIncreasedthicknessNormalThicknessRightvent.dysfunctionPulmonaryhypertensionIsolatedpre-dominantRVMINomitralobstructionMitralobstructionMS,atrialmyxomaPericardialdis.TamponadeConstrictionNopericardialdiseaseInducibleischemiaIntermittent/activeische
8、miaNo
