2013年美国心力衰竭管理指南(心衰指南)-英文

Elevation Myocardial Infarction

Guidelines for the Management of Patients With Valvular Heart Disease

Comprehensive Heart Failure Practice Guideline

Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart

Failure

Chronic Heart Failure: Management of Chronic Heart Failure in Adults in

Primary and Secondary Care

Statements

Appropriate Use Criteria for Coronary Revascularization Focused Update ACCF/AHA HFSA ESC NICE ACCF 2008 (17) 2010 (18) 2012 (19) 2010 (20) 2012 (26) Seventh Report of the Joint National Committee on Prevention, Detection, NHLBI 2003 (27) Evaluation, and Treatment of High Blood Pressure

Implications of Recent Clinical Trials for the National Cholesterol Education NHLBI 2002 (28) Program Adult Treatment Panel III Guidelines

Referral, Enrollment, and Delivery of Cardiac Rehabilitation/Secondary AHA/AACVPR 2011 (29) Prevention Programs at Clinical Centers and Beyond

Strategies and Patient Selection

Advanced Chronic Heart Failure ESC 2007 (32) Oral Antithrombotic Agents for the Prevention of Stroke in Nonvalvular AHA/ASA 2012 (33) Atrial Fibrillation

Third Universal Definition of Myocardial Infarction ESC/ACCF/AHA/WHF 2012 (34) AACVPR indicates American Association of Cardiovascular and Pulmonary Rehabilitation; AATS, American Association for Thoracic Surgery; ACCF, American College of Cardiology Foundation; ACCP, American College of Chest Physicians; ACP, American College of Physicians; AHA, American Heart Association; ASA, American Stroke Association; ESC, European Society of Cardiology; HFSA, Heart Failure Society of America; HRS, Heart Rhythm Society; ISHLT, International Society for Heart and Lung Transplantation; NHLBI, National Heart, Lung, and Blood Institute; NICE,

National Institute for Health and Clinical Excellence; PCNA, Preventive Cardiovascular Nurses Association; SCAI, Society for Cardiovascular Angiography and Interventions; STS, Society of Thoracic Surgeons; and WHF, World Heart Federation.

2. Definition of HF

HF is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. The cardinal manifestations of HF are dyspnea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary and/or splanchnic congestion and/or peripheral edema. Some patients have exercise intolerance but little evidence of fluid retention, whereas others complain primarily of edema, dyspnea, or fatigue. Because some patients present without signs or symptoms of volume overload, the term “heart failure” is preferred over “congestive heart failure.” There is no single diagnostic test for HF because it is largely a clinical diagnosis based on a careful history and physical examination.

The clinical syndrome of HF may result from disorders of the pericardium, myocardium, endocardium, heart valves, or great vessels or from certain metabolic abnormalities, but most patients with HF have symptoms due to impaired left ventricular (LV) myocardial function. It should be emphasized that HF is not synonymous with either cardiomyopathy or LV dysfunction; these latter terms describe possible structural or functional