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热烈祝贺
第十次中国中西医结合学会心血管病学术会议
在江西南昌隆重召开
(中国南昌,
大会名誉主席:
陈可冀 陈凯先 陈灏珠 胡大一 高润霖 沈自尹 王士雯 张伯礼
张 运 戴瑞鸿 吴以岭 刘力生 丁 健 魏云峰 程晓曙
大 会 主 席:范维琥
大会执行主席:黄绍烈
The Treatment Of Chronic Heart Failure In 21st Century: The Era Of Biomedical Engineering Coming
Chun-Song Hu, MD1, Da-Yi Hu, MD2, 4, and Shen-Shou Hu, MD3, et al.
1. Department of Cardiovascular Medicine,
2.
3. Department of Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. huss@vip.sohu.com
4.
5. ……
Abstract: Chronic heart failure (CHF) is a challenging problem in clinical work. Its therapeutic strategy developed rapidly with 21st century coming from traditional internal medical therapy, which used mainly the program of angiotensin converting enzyme inhibitors (ACEI) + beta blockers to a variety methods of biomedical engineering, which include interventional engineering such as percutaneous balloon mitral valvotomy (PBMV), percutaneous coronary intervention (PCI), catheter ablation(CA), cardiac resynchronization therapy(CRT) such as biventricular and right ventricular DDD Pacing, and implantable cardioverter defibrillator (ICD); mechanical engineering such as left ventricular assistant device (LVAD), internal artery balloon counterpulsation (IABP), external counterpulsation (ECP) / enhanced ECP (EECP), cardiac support device (CSD) and total artificial heart(TAH); surgical engineering such as coronary artery bypass graft (CABG), valve replacement or repair of rheumatic or congenital heart diseases(CHD) and heart transplantation(HT); regenerate engineering including gene therapy, stem cell transplantation and tissue engineering as well as rehabilitating engineering including exercise training, low-salt diets, nursing, psychological interventions and health education(HE). These therapies of biomedical engineering make symptoms of CHF improved greatly and life expectancy lengthened. So far, pharmacotherapy, which based on evidence-based medicine (EBM), large-scale, multi-center, randomized controlled clinical trials, is still a major choice for CHF in clinical and, we think that the current application of device therapy including interventional engineering and mechanical engineering in patients with advanced CHF is not enough probably due to patients’ individual status. In stead of HT and TAH, stem cell technology of regenerate engineering for middle and end-stage heart failure is very promising, in light of both efficacy and feasibility, which based recent results of basic and clinical research. However, each therapy has its advantages and disadvantages, combination-based synthetic treatment is more promising a strategy for the treatment of CHF. From all above, we think that the era of biomedical engineering for CHF has coming and now it is possible for us to choose the better therapeutic strategies for patients with CHF according to cost-efficacy analysis of these therapies.
Keywords: chronic heart failure, treatment, biomedical engineering
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