3. myocardium impaired and remodeling initial myocardium impaired .secondary conduct ventricular overload factor myocardium infarction inflammation sympathetic nervous system PRAAs endothelins disease progress chamber enlargement heart failure myocardial hypertrophy TNF-aIL-6 complication embryo gene phenotype .mechanical stress death extracellular matrix change .oxidative stress
• 3.myocardium impaired and remodeling initial myocardium impaired ventricular overload myocardium infarction inflammation disease progress heart failure complication death chamber enlargement myocardial hypertrophy embryo gene phenotype extracellular matrix change •secondary conduct factor •sympathetic nervous system •RAAS •endothelins •TNF-α ,IL-6 •mechanical stress •oxidative stress
4. Diastolic heart failure Heart failure may develop as a result of poor ventricular filling and high filling pressure caused by abnormal ventricular relaxation
• 4.Diastolic heart failure Heart failure may develop as a result of poor ventricular filling and high filling pressure caused by abnormal ventricular relaxation
正常 压力 顺应性 顺应性 容积 图324心室舒张末期压力和容积的关系 舒张性心力衰竭时,心室顺应性降低,心室压力容积曲线 向左上方移位,即在任何特定的舒张末期压时,心室末期 容量小于正常人
顺应性 ↓ 顺应性 ↑ 正常 压 力 图3–2–4 心室舒张末期压力和容积的关系 舒张性心力衰竭时，心室顺应性降低，心室压力–容积曲线 向左上方移位，即在任何特定的舒张末期压时，心室末期 容量小于正常人。 容 积
a. sarcoplasmic reticulum intake Ca2+ relaxation free Ca2+ in myocyte degrade slowly! dysfunction b In Chd with obvious ischemia, before contractility dysfunction, have occurred relaxation dysfunction In hypertrophy and hypertrophic cardiomyopathy, left ventricular end-diastolic filling pressure pulmonary hypertension pulmonary congestion diastolic heart failure
a. sarcoplasmic reticulum intake Ca2+ free Ca2+ in myocyte degrade slowly b. In CHD with obvious ischemia ,before contractility dysfunction, have occurred relaxation dysfunction c. In hypertrophy and hypertrophic cardiomyopathy, left ventricular end-diastolic filling pressure pulmonary hypertension ,pulmonary congestion diastolic heart failure relaxation dysfunction
Type of heart failure Heart failure can be described or classified in several wavs 1. Acute and chronic heart failure 2. Left right and biventricular heart failure 3. High and low output heart failure 4. Diastolic and systolic dysfunction 5.Asymptomatic and congestive heart failure
Type of heart failure Heart failure can be described or classified in several ways. • 1. Acute and chronic heart failure • 2. Left ,right and biventricular heart failure • 3. High and low output heart failure • 4. Diastolic and systolic dysfunction • 5.Asymptomatic and congestive heart failure