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对慢性心功能不全患者,应用常规治疗措施(休息、饮食、洋地黄和利尿剂等)不能改善其充血性心力衰竭状态,对治疗无反应,即称之为难治或顽固性慢性心力衰竭。慢性心力衰竭的病理生理慢性心力衰竭是心肌收缩力受到原发性的及继发性的抑制和减低或心室血液动力学极度负荷过重则导致心功能失代偿。心功能是由调节心搏量和心排出量的四个主要因素所控制:(1)前负荷——心室充盈压;(2)后负荷——喷血期心室的张力;(3)收缩力——与负荷无关的收缩力;(4)心率。当心脏长期血液动力学负荷过度或原发性收缩力障碍,有三个代偿机制以维持休息时正常的心排出量:(1)心室扩张——Fra-
Chronic heart failure patients, the application of conventional treatment measures (rest, diet, digitalis and diuretics, etc.) can not improve their state of congestive heart failure, no response to treatment, which is called refractory or refractory chronic heart failure. Pathophysiology of Chronic Heart Failure Chronic heart failure is a condition in which primary and secondary myocardial contractility is inhibited and reduced or extreme overload of ventricular hemodynamics leads to cardiac decompensation. Cardiac function is controlled by four major factors that regulate stroke volume and cardiac output: (1) preload - ventricular filling pressure; (2) postload - tension of the ventricle during the ejection phase; (3) contractility - The load has nothing to do with contractility; (4) Heart rate. When the heart has long-term hemodynamic overload or primary contractile force, there are three compensatory mechanisms to maintain normal cardiac output at rest: (1) ventricular dilation - Fra-