symptoms Asymptomatic at rest Class Ⅳ Inability to carry out any physical activity without fort Sympotoms at rest Stage and Class of HF ?心衰分期是 NYHA 分级的补充,但不能替代 NYHA 分级?NYHA 分级–在具体病人可上下变动(对治疗的反应和/或疾病进程不同) ?分期–随心脏重构加重只能进展 6-min walk distance mild degree : >450m moderate degree : 150-450m severe degree :<150m Evaluation of chronic HF cardiac function Fundamental causes 1. primary myocardial disease 2. increased burdens to the heart Fundamental causes 1. primary decreased myocardial contractility A. coronary heart disease B. myocarditis ,cardiomyopathy C. myocardial metabolic disorder Fundamental causes 2. increased burdens to the heart ① increased afterload (pressure load): A. hypertension B. aortic stenosis C. pulmonary stenosis D. pulmonary hypertension
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