CẬP NHẬT CHÂN ĐOÁN &
ĐIỀU TRỊ SUY TIM 2016

GS.TS.HUỲNH VĂN MINH, FACC
P. Chủ tịch Hội Tim mạch Việt nam
GĐ Trung tâm Tim mạch BVĐHYD Huế


ĐẶT VẤN ĐỀ


TỈ LỆ SUY TIM TRÊN TOÀN THẾ GIỚI 2014


SỐ CA MỚI MẮC / NĂM SUY TIM Ở CÁC VÙNG CỦA WHO

Region
Africa
America
Mediterranean
Europe
Southeast Asia
West Pacific
World

New cases in millions / year
0.5 M
0.8 M
0.4 M
1.3 M
1.4 M

South Korea

20 %

21 %

Japan

47 %

19 %

Hong Kong

36 %

21 %

China

20 %

24 %

Thailand

65 %

47 %


Malaysia

49.5%

28.9%

25.8%

4.1%

69 %

Singapore

67.6%

50.3%

46.8%

16.5%

67.6%

90 %
39 %

66 %

60 %

27,0% 27,0%

11,3%

20
24,5%
10

4,4%
10,1%
0,0%

0

Mai Van Thuat, Huynh van Minh, Some aspects of hospitalised HF patients n Hue University Hospital, 2016


How about in Vietnam ?
90
80
70

81,8%

78,6% 74,8%

60
50

40

n

%

≥50

Preserved EF

105

66,0

41 – 49

Bordeline EF

36

22,6

≤40

Reduced EF

18

11,3

(%)


Classification

Ejection
Fraction

Description

I. Heart Failure with
Reduced Ejection
Fraction (HFrEF)

≤40%

Also referred to as systolic HF. Randomized clinical trials have
mainly enrolled patients with HFrEF and it is only in these
patients that efficacious therapies have been demonstrated to date.

II. Heart Failure with
Preserved Ejection
Fraction (HFpEF)

≥50%

Also referred to as diastolic HF. Several different criteria have
been used to further define HFpEF. The diagnosis of HFpEF is
challenging because it is largely one of excluding other potential
noncardiac causes of symptoms suggestive of HF. To date,
efficacious therapies have not been identified.

a. HFpEF, Borderline



3. HAI NHÓM THUỐC ĐIỀU TRỊ
SUY TIM MỚI


Pharmacologic Treatment for Stage C HFrEF
HFrEF Stage C
NYHA Class I – IV
Treatment:

Class I, LOE A
ACEI or ARB AND
Beta Blocker

For all volume overload,
NYHA class II-IV patients

For persistently symptomatic
African Americans,
NYHA class III-IV

For NYHA class II-IV patients.
Provided estimated creatinine
>30 mL/min and K+