- PowerPoint PPT Presentation

1 / 35
About This Presentation
Title:

Description:

Title: Author: Image Last modified by: Created Date: 3/17/2006 8:49:31 AM Document presentation format: (4:3) – PowerPoint PPT presentation

Number of Views:14
Avg rating:3.0/5.0
Slides: 36
Provided by: imag161
Category:

less

Transcript and Presenter's Notes

Title:


1
ß?????????????
  • ?????????
  • ??? ???
  • 2008?06?20?

2
??
  • ??ß?????????
  • ????ß?????
  • ??ß????????
  • ??

3
?????????????
  • ???????????????????????????????????????
  • ???,???????????,????????????
  • ??????????????0.23-0.37
  • ????????????200???

4
?????????????
100 90 80 70 60 50 40 30 20
???
???
????
??????
?????
??????
?????
0 1 2 3 4 5 6
??????
5
?????????????????
Grace?? Steg et al Circulation 2004
6
  • ?????

7
???????????
  • ?????????????????????????,????????????
  • ??????????????????????,??????
  • ACC/AHA????????????????

8
????????????????????
??????
9
????????????????
????
??
????
????
  • ????

????
???
????
????,LVH
????
???? (HT, LDL ?, DM?)
??????
10
????????????????
  • NE????
  • ?,ß????

????? ????
?????? ?????
???
????
???? ??
???? ????
??????
????
????
?????? ?????
11
???????????????
????
  • SNS????????????,??????????

????,??????, ???????,????
??????? RAAS????
???,????? ????????
??????? ????????
12
????????????????????
40 35 30 25 20
???? ????
? ? ? ? ? ? ? ()



Plt0.05 Plt0.0001 P0.013 ,???????
?? ??? ??? ???
Hall SA, et al. J Am Coll Cardiol
1995351154-1161
13
(No Transcript)
14
????????ß?????CAPRICORN (n1959)? MERIT-HF
(n1926)
????
P?
???/ß?????
??????
151/116 122/74
CAPRICORN
23
p0.03
?????1 ?2 (?1)
MERIT-HF
40
p0.0004
??????? ?1
??????/?????
367/340 326/258
8
CAPRICORN
ns
?????1 ?2 (?1)
p0.002
MERIT-HF
22
??????? ?1
0.0
1.0
?????95 CI
The CAPRICORN Investigators. Lancet
20013571385-1390. Janosi A et al. In
preparation.
15
ß????? ???????????
SOLVD-T (1991) ??????21
MERIT (1999) ?????? 34
CHARM-Added (2003) (? ???????) ??????30
??? ??? ACE???/ ARB ? ?????
??? ??? ACE??? ? ?????
??? ??? ACE??? ? ?????
??? ???
??? ??? ACE???
??? ??? ACE???
16
????????
  • ??10000????20?????????????????
  • ?????LVEFlt35-45,?????????ACEI,????????????
  • ?ACEI??,ß??????????????????,?ACEI?????????????,???
    ??35

17
??????????????
  • ??????????????,b1/ b2 / a1 ?2 1 1
  • b1????????????????????
  • ??
  • ??????????b1??????????,??????????

18
ß?????ß1?????????
  • ?????????????,??????
  • ?????????
  • ???????
  • ????,???????,???????
  • ????????????,?????????
  • ???

19
ß???????????????
?????
????
????
????
????
??????
20
????????????????- ??????????????
????
????,??????, ???????,????
??????? RAAS????
??????? ????????
???,????? ????????
????????????????????? 2002, 30(1)7-23
21
(No Transcript)
22
  • ???

23
ß?????????????
  • ??LVEF???????????,???????????
  • ?????????,???????????

24
ß??????????
  • ????????
  • ????(??lt60?/min)??????,???????????
  • ???
  • ???

25
ß??????????????
  • ?????,???????????????
  • ??ACEI???????????????
  • ??????,?????,????????,??????????????
  • ???????????????
  • ???????????????

26
??ß??????????????
  • ?????????
  • ??
  • ?????????
  • ???

27
????????????ß?????
  • ????
  • ????
  • ???? ???- ??????
  • ????

28
3?ß-?????????
  • ????
  • ???? 6.25mg BID
  • ???? 1.25mg QD
  • ???? 3.125mg BID
  • ?????
  • ????200mg/d
  • ????10mg/d
  • ????100mg/d
  • ????
  • ?1-2???????
  • ?2-4?????
  • ???
  • 60-70bpm

29
  • ????

30
??????????ß??????
?? ?? ?? ?????? ?????? ????? ?????
?? ?? ?? ??? ?-??? ??? ?-???
Gunderson 1884 ???? 138 (15.5) 92 (10.3) 14 (30.5) 6 (11.3)
BHAT 3837 ???? 155 (9.2) 116 (6.9) 33 (14.4) 22 (9.3)
Kjekshus 1670 ???? 103 (12.8) 42 (6.5) 33 (23.4) 13 (10.2)
?? 7391 396 (11.7) 250 (7.8) 80 (19.2) 41 (9.9)
?-???????? ?-???????? ?-???????? 33 33 48 48
31
????????????ß??????
1.0 0.8 0.6 0.4 0.2 0.0
Proportion Surviving
Gottlieb SS et al N Eng J Med 1998339489
32
??????????ß??????
?? ???? ?? ?? ?????
????? 90? 65-74 ???? 45(p0.032)
??????? ??61? 65-74 ???? 19(p0.022)
?-?????? ??25? 60-69 ???? 33(plt0.031)
33
?????????????????ß??????
  • ??????,????
  • ???????II?III?????,???
  • ?????ß?????,?????????????????

ACC/AHA????????????????
34
???????
  • ??A??????????,?????????,??,??????ACEI
  • ??B??A?????,?????ACEI,?????ß?????
  • ??C??A?????,??????? ACEI?ß?????????
  • ??D??A?B?C?????,??????,????,???????????????,????

ACC/AHA????????????????
35
??
  • ??????????ß??????
  • ????????
  • ????????
  • ????????
  • ?????????
Write a Comment
User Comments (0)
About PowerShow.com