心脏起搏器培训资料：心衰基本常识与CRT植入适应证 (2)

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1、A，B和C：A示健康人在前负荷增加（心室充盈時肌体的拉伸）心脏能力的增加；B示同樣个体有进展性的LV收縮能力下降時，会有延伸的代偿性的舒張容积增加，但少于正常人的每搏輸出量；C代表随着心衰的加重，代偿机制最大，引起肺充血，心輸出量下降而运动困难。最终由于心肌代偿能力下降而使曲线逐步向下Packer.Progr Cardiovasc Dis.1998;39(suppl I):39-52.CNS 交感疾病进展 心脏交感活性1-receptors2-receptors1-receptors血管收缩，水钠滞留心脏毒性，心律失常增加 肾脏交感活性+周围血管床Activationof RAS1-1-血管收

2、缩氧化应激细胞生长蛋白尿LV 重构血管重构血管紧张素原血管紧张素 I血管紧张素 IIAT I 受体肾素血管紧张素转换酶I IIaIIbIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIIIIaIIaIIa IIbIIbIIb IIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIII

3、IIIIIaIIaIIa IIbIIbIIb IIIIIIIII*All primary SCD prevention ICD recommendations apply only to patients who are receiving optimal medical therapy and have reasonable expectation of survival with good functional capacity for more than 1 year.I I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbI

4、IIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIIIIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIIIIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIII I I IIaIIaIIa IIbIIbIIbIIIIIIIIIIIaIIaIIa IIbIIbIIbIIIIIIIII*All primary SCD prevention ICD recommendations apply only to patients who are receiving optimal medical therapy and have reasonable expectation of survival with good functional capacity for more than 1 year.