肥厚性梗阻性心肌病的诊断与治疗.pptx

肥厚型梗阻性心肌病的现代治疗Current Therapy of HypertrophicObstructive Cardiomyopathy;Etiology of Hypertrophic Cardiomyopathy (HCM);Pathophysiology of HCM;Pathophysiology of HCM;;临床表现;临床体征;Diagnosis of HCM; LVOTPG;SAM现象;LVOTPG;MRI诊断;Obstructive Mechanism;Obstructive Mechanism;激发试验—隐匿性梗阻;HCM管理流程;Therapy;Beta-blockers;Calcium Antagonists ;Journal of Cardiology?2014 64, 1-10DOI: (10.1016/j.jjcc.2014.02.022) ;In Conclusion;Journal of Cardiology?2014 64, 1-10DOI: (10.1016/j.jjcc.2014.02.022) ;Cibenzoline ;Journal of Cardiology?2014 64, 1-10DOI: (10.1016/j.jjcc.2014.02.022) ;Cibenzoline ;In Conclusion;Medical Therapy;How to reduce the hypertrophy?;Therapy;HCM介入和外科疗效和特点;Short and Medium Term Outcomes of Surgery for?Patients With HOCM- between 2001 and 2011, n=211 ;Complications of Surgery for HCM ;Long-Term Follow-Up of Medical Versus Surgical Therapy for Hypertrophic Cardiomyopathy: A Retrospective Study ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;J Am Coli CardioI1991,'17:634-42 ;Conclusions. In severely symptomatic patients and those with hypertrophic cardiomyopathy and large pressure gradi- ents, clinical follow-up results are best with combined treat- ment with septal myectomy and chronic verapamil therapy. Mildly symptomatic patients with no or mild outflow tract obstruction probably benefit most from treat- ment with verapamil. ;Percutaneous Transluminal Septal Myocardial Ablation (PTSMA);Indications;Alcohol Septal Ablation (SAS);Alcohol Septal Ablation (SAS);SAS前的初步评估;冠脉造影：评估冠脉病变和间隔支;较适宜PTSMA：室间隔基底段肥厚为主;冠脉造影和左室造影;左心室造影评估;流出道最窄处距主动脉瓣约25mm压差80mmHG;LVOTPG;综合评估理想病例;LVOTPG (PG=219mmHg);PTSMA术;PTSMA术中精准评估;术中精准确定靶间隔支;术中精准确定靶间隔支;;MCE提高PTSMA安全性;;PTSMA术—注入无水酒精;;国内外各组术者PTSMA急性期疗效;疗效和随访—PTSMA; 磁共振随诊; Am J Cardio 2010;106:1487-1491. (IF 3.9)院所青年基金;同位素心肌灌注显像示PTSMA术后患者室间隔灌注有不同程度的减低 ;PTSMA术并发症;Fuwai Hospital Data(n=310)