2013年美国心力衰竭管理指南(心衰指南)-英文

Table of Contents

Preamble ................................................................................................................................................................ 6

1. Introduction ....................................................................................................................................................... 8

1.1. Methodology and Evidence Review ............................................................................................................. 8

1.2. Organization of the Writing Committee ....................................................................................................... 9

1.3. Document Review and Approval .................................................................................................................. 9

1.4. Scope of This Guideline With Reference to Other Relevant Guidelines or Statements ............................. 10

2. Definition of HF ............................................................................................................................................... 12

2.1. HF With Reduced EF (HFrEF) ................................................................................................................... 13

2.2. HF With Preserved EF (HFpEF) ................................................................................................................. 13

3. HF Classifications ........................................................................................................................................... 14

4. Epidemiology ................................................................................................................................................... 15

4.1. Mortality ..................................................................................................................................................... 16

4.2. Hospitalizations........................................................................................................................................... 16

4.3. Asymptomatic LV Dysfunction .................................................................................................................. 16

4.4. Health-Related Quality of Life and Functional Status ................................................................................ 16

4.5. Economic Burden of HF ............................................................................................................................. 17

4.6. Important Risk Factors for HF (Hypertension, Diabetes Mellitus, Metabolic Syndrome, and

Atherosclerotic Disease) .................................................................................................................................... 17

5. Cardiac Structural Abnormalities and Other Causes of HF ...................................................................... 18

5.1. Dilated Cardiomyopathies .......................................................................................................................... 18

5.1.1. Definition and Classification of Dilated Cardiomyopathies .............................................................. 18

5.1.2. Epidemiology and Natural History of DCM ..................................................................................... 19

5.2. Familial Cardiomyopathies ......................................................................................................................... 19

5.3. Endocrine and Metabolic Causes of Cardiomyopathy ................................................................................ 20

5.3.1. Obesity............................................................................................................................................... 20

5.3.2. Diabetic Cardiomyopathy .................................................................................................................. 20

5.3.3. Thyroid Disease ................................................................................................................................. 20

5.3.4. Acromegaly and Growth Hormone Deficiency ................................................................................. 20

5.4. Toxic Cardiomyopathy ............................................................................................................................... 21

5.4.1. Alcoholic Cardiomyopathy ............................................................................................................... 21

5.4.2. Cocaine Cardiomyopathy .................................................................................................................. 21

5.4.3. Cardiotoxicity Related to Cancer Therapies ...................................................................................... 21

5.4.4. Other Myocardial Toxins and Nutritional Causes of Cardiomyopathy ............................................. 22

5.5. Tachycardia-Induced Cardiomyopathy ....................................................................................................... 22

5.6. Myocarditis and Cardiomyopathies Due to Inflammation .......................................................................... 22

5.6.1. Myocarditis ........................................................................................................................................ 22

5.6.2. Acquired Immunodeficiency Syndrome ............................................................................................ 23

5.6.3. Chagas’ Disease ................................................................................................................................ 23

5.7. Inflammation-Induced Cardiomyopathy: Noninfectious Causes ................................................................ 23

5.7.1. Hypersensitivity Myocarditis ............................................................................................................ 23

5.7.2. Rheumatological/Connective Tissue Disorders................................................................................. 24

5.8. Peripartum Cardiomyopathy ....................................................................................................................... 24

5.9. Cardiomyopathy Caused By Iron Overload ................................................................................................ 24

5.10. Amyloidosis .............................................................................................................................................. 25

5.11. Cardiac Sarcoidosis ................................................................................................................................... 25

5.12. Stress (Takotsubo) Cardiomyopathy ......................................................................................................... 25

6. Initial and Serial Evaluation of the HF Patient ............................................................................................ 26

6.1. Clinical Evaluation...................................................................................................................................... 26

6.1.1. History and Physical Examination: Recommendations ..................................................................... 26

6.1.2. Risk Scoring: Recommendation ........................................................................................................ 27

6.2. Diagnostic Tests: Recommendations .......................................................................................................... 29