ISBN 978-974-06-1039-7

(quality of evidence)
(strength of recommendation)

1.
2. loop diuretics, thiazides
3. angiotensin-aldosterone
4. beta-adrenergic receptor antagonist (- blocker)
5. 40% patients with heart failure with
preserved left ventricular ejection fraction (HF with PLVEF)
6.
7.

1
2
3
3
3
3
4
8
13
19
22
24
27
35

1
2
3
4
5
6
7
8
9
10
11
12
13
14

7

7

9
angiotensin converting enzyme inhibitor, angiotensin II receptor 17
blocker aldosterone
renin-angiotensin-aldosterone system 18
aldosterone antagonist
19
- blocker
20

22

27

28

31

31

2
renin-angiotensin aldosterone system
3
left ventricular systolic dysfunction

6
14
33


(Quality of Evidence)
1
systematic review randomized controlled clinical trials well
designed randomized controlled clinical trial
2
systematic review controlled clinical trials well designed
controlled clinical trial
( cohort study, casecontrol study)
3
descriptive studies controlled clinical trial

4
( consensus )
(Strength of Recommendation)
++

+/-


-

- -

1.
2.
3.
4.

()
()

(PCI)
(CABG)


5
550,000 .. 2548 2.9



20

(acute heart failure)

2



(rheumatic)

2
1. ()

2.

++
1.
1 (3)
2.
NYHA functional class (NYHA FC) (3)
3.
(3)
4.
2 (3)

 +
1. 3
( 3)

1
1
(BNP=brain natriuretic peptide, NTproBNP = N-terminal pro brain natriuretic peptide)

/ BNP/NTproBNP

Echocardiogram

coronary angiogram

precipitating factors

 1
atherosclerosis

anthracyclines, trastuzumab,
cyclophosphamide mediastinum
systemic collagen vascular disease, thyroid disorder,

2
- Complete blood count
- Urinalysis
- Blood chemistry : serum electrolytes, blood urea nitrogen, serum creatinine, fasting plasma glucose, lipid profile
- 12 - Lead electrocardiogram
- Chest X-ray
- Echocardiogram and Doppler study (where avialable)

*

3
Plasma B-type natriuretic peptide (BNP nt-ProBNP)*
Liver function test, thyroid function test
Screening for hemochromatosis, sleep-disturbed breathing
Screening for HIV infection
Diagnostic tests for rheumatologic diseases, amyloidosis pheochromocytoma
Noninvasive imaging myocardial ischemia and viability (
revascularization)
- Coronary angiography ( revascularization)
- Endomyocardial biopsy pathology
inflammatory disease
- Exercise stress testing

* natriuretic peptide
pulmonary embolism


Loop diuretic, thiazide
++
1.

( 1)
2. randomized controlled trials
angiotensin
converting enzyme inhibitor (ACEI) / - blocker ( 3)
Potassium-sparing diuretics
1. Potassium-sparing diuretics ACEI
ACEI spironolactone
( ++, 3)
2. spironolactone spironolactone
amiloride triamterene
( +-, 3)
3. potassium-sparing diuretics ( -,
3)
4. potassium-sparing diuretics creatinine 5-7

3-6 potassium sparing diuretics
5 / creatinine 2.5 ./.

Loop diuretic thiazide ACEI

thiazide GFR< 30 ./ loop diuretics

loop diuretic thiazide ( )
loop diuretic 2
Potassium-sparing diuretic: triamterene, amiloride spironolactone
ACEI

5-7 5-7

5 diuretics ESC guidelines 2005

Agents
Loop diuretic
Furosemide
Torasemide
Thiazide
HCTZ
Potassium-sparing
diuretic
Amiloride
Triamterene
Spironolactone

Initial dose

Maximum/day

20-40 mg OD or bid
5-10 mg OD

250-500 mg
100-200 mg

25 mg OD

50-75 mg

Initial dose
With ACEI
Without ACEI
5 mg
2.5 mg OD
50 mg
25 mg OD
50 mg
12.5-25 mg OD

Major side effects

Hypokalemia, Hypomagnesemia, Hyponatremia
Acid base disturbance
Hypokalemia, Hypomagnesemia, Hyponatremia
Maximum/day
With ACEI
Without ACEI
20 mg OD
40 mg
200 mg
100 mg OD
100-200 mg
50 mg OD

 cardiac glycosides positive inotropic agents

++
atrial fibrillation (AF)
left ventricular dysfunction cardiac glycoside ventricular rate ventricular
function ( 2)
+
1. AF digoxin - blocker
( 2)
2. left ventricular systolic dysfunction (LVSD)
sinus rhythm ACEI, - blocker spironolactone digoxin
(
1)
3. cardiac glycoside second third-degree AV block, sick
sinus syndrome, carotid sinus syndrome, Wolff-Parkinson-White syndrome, hypertrophic obstructive
cardiomyopathy, hypokalemia hyperkalemia
4. digoxin amiodarone, verapamil, erythromycin, tetracycline
diuretics drug interaction
Digoxin
+
1. Digoxin 0.125-0.25 ./
0.0625-0.125 . digoxin
0.5-0.9 ./. ( 3)
2. digoxin digitalis intoxication
digoxin digoxin 6-8
( 3)
Positive inotropic agents (dopamine, dobutamine, milrinone)
1.
peripheral hypoperfusion

10

2. - blocker
inotropic drug dobutamine - blocker

1-

blocker - blocker phosphodiesterase inhibitor milrinone

- blocker - blocker
cardiac arrhythmia milrinone
3. inotropic drugs

(cardiac transplantation)

anti-thrombotic agents
Anti- thrombotic 2 antiplatelets aspirin, clopidogrel oral
anticoagulants warfarin
sinus rhythm
thromboembolic events anticoagulant
antiplatelets thromboembolic events ( 2)

antiplatelets aspirin clopidogrel

+
1. aspirin (atherothrombotic diseases)

( 3)
2. clopidogrel anticoagulants aspirin (
3)
aspirin non-ischemic cardiomyopathy
(atherosclerosis) ( 3)

11

 anticoagulants warfarin
++
anticoagulant warfarin INR 2-3
thromboembolic events (
1)
-

AF systemic emboli

pulmonary emboli, venous thrombosis

(LV thrombus)

+
anticoagulant AF ( 2 3)
+/ anticoagulant (
2 3)
-

(LVEF < 35%)

(left ventricular aneurysm)

Recent large MI anterior wall MI anticoagulant 3-4

anticoagulant (
2)

anti-arrhythmic agent (Vaughan Williams classification)

- blocker anti-arrhythmics
AF, atrial flutter, non-sustained sustained ventricular tachycardia
(VT)

Anti-arrhythmics class I
anti-arrhythmic 1
ventricular arrhythmia ( 2)
12

Anti-arrhythmics class II
++
- blocker sudden
cardiac death ( 1)
+
- blocker amiodarone (device therapy) sustained
non-sustained VT ( 3)

Anti-arrhythmics class III

1. AF electrical cardioversion amiodarone

2. amiodarone
( -, 1)
Renin - Angiotensin Aldosterone (RAS)
neuro-hormonal system homeostasis
sympathetic RAS system
noradrenalin, angiotensin II aldosterone
vasoconstrictor peripheral vascular resistance
/ apoptosis fibrosis down regulation adrenergic receptor endothelial dysfunction
2
1. noradrenalin angiotensin II

2. noradrenalin angiotensin II
(mortality and morbidity)
RAS ( 2)
1. renin - blocker
2. enzyme angiotensin I angiotensin II ACEI
3. angiotensin receptor angiotensin II receptor blocker (ARB)
4. aldosterone receptor aldosterone antagonist (AA)
13

Angiotensin

Renin - blocker
Angiotensin I

ACE ACEI
Angiotensin II

ARB
AT1 receptor

Aldosterone

AA
Aldosterone receptor

2 renin
angiotensinaldosterone system - blocker,
angiotensin converting enzyme inhibitor
(ACEI), angiotensin II type I receptor (AT1),
angiotensin receptor blocker (ARB),
aldosterone receptor aldosterone receptor
antagonist (AA)

RAS ACEI

stroke

- blocker, digitalis
ACEI
ACEI (functional capacity)
ACEI

(systolic BP) 80 .
creatinine 3 ./ 5.5 / bilateral renal artery stenosis
angioedema ACEI

ACEI

( 6)

ACEI

14

ACEI - blocker ACEI

ACEI ACEI AA

(nonsteroidal anti-inflammatory, NSAID, Coxib) ACEI aspirin
NSAID aspirin ACEI
ACEI (7)

1. ACEI, 1-2 3-6

2. ACEI AA ARB
3.
4.
ACEI ARB AA
ARB AA RAS
3 (ACEI+ARB+AA) ACEI ARB
ACEI ARB
ACEI ARB (6)
spironolactone (12.5-50 ./) ACEI, loop diuretic digoxin


ACEI ARB ( 8) creatinine
2.5 ./ 5 / painful gynaecomastia

RAS
1. 2-3
ACEI hypovolemia (
130 mEq/L)


2. ACEI creatinine 0.3 ./. 15-30%
5-15% bilateral renal
artery stenosis NSAID ACEI
15

 azotemia
ACEI
3.
AA
/ ACEI ARB
4. ACEI 5-10% 30-40%
1-2
ACEI ACEI
ARB
ACEI
5. Angioedema 1%
ACEI ARB ARB
ACEI ARB angioedema ACEI

RAS
++
1. ACEI LVSD (EF< 40-45%)

( 1)
2. ACEI

( 1)
3. ACEI ACEI
( 2)
4. ACEI (
1) ( 3)
5. ARB ACEI ACEI
mortality morbidity ( 2)
6. ARB ACEI
LVSD ( 1)
7. AA ACEI, - blocker (NYHA FC III-IV)
mortality morbidity ( 2)

16

 +
1. ACEI ( 1) ARB ( 3)
(atherosclerotic vascular
disease)
2. ARB ACEI mortality morbidity
ARB ( 2)
3. ARB ACEI
( 2)

1. ACEI ARB bilateral renal artery stenosis
2. ACEI angioedema ACEI (
1)
3. ACEI ARB AA (
3)
6 Angiotensin Converting Enzyme Inhibitor (ACEI), Angiotensin Receptor
Blockage (ARB) Aldosterone Antagonist (AA) ( *
** perindopril heart failure with preserved LV systolic function)

()
(.) ()
(.)
ACEI ARB
ACEI
6.25
3
25-50
3
Captopril*
2.50
1-2
10-20
2
Enalapril*
1.25-2.5
1
2.5-5
2
Ramipril*
2.5-5
1
20-40
1
Lisinopril*
1.0
1
4
1
Trandolapril*
2.0
1
8-16
1
Perindopril**
5.0
2
20
2
Quinapril
5-10
1
40
1
Fosinopril
ARB
4-8
1
32
1
Candesartan*
20-40
2
160
2
Valsartan*
25-50
1
50-100
1
Losartan*
17

Telmisartan
Eprosartan
Irbesartan
Olmesartan
AA
Spironolactone

12.5-25

40-80
400-800
150-300
20-40

1
1
1
1

25

1-2

7 RAS
1
2
3
2-3
4
5 ( creatinine 50 3 ./.)
6
7 NSAID Coxib
8 1-2 3
3-6
9
1.
2. Systolic BP 100 .
3. creatinine 1.7 ./.
4. 130 /
5.
6.

18

 8 aldosterone antagonist (AA)

1 (NYHA FC III-IV)
ACEI/ARB
2 ( 5 /) creatinine (
2.8 ./. )
3
4 creatinine 4-6
5 5-5.5 / 50% 5.5 /

beta-adrenergic receptor antagonist (- blocker)

++
1. LVSD (NYHA FC II-IV)
ACEI
(1)
2. - blocker sudden death
NYHA FC
(1)
3. LVSD - blocker
ACEI (1)
4. - blocker carvedilol, metoprolol, bisoprolol nebivolol (1)

- blocker
( 9)
3-6
- blocker

- blocker
1. hemodynamic
- blocker
2. 2 1-2

19

3.
3.1
3.2 ACEI - blocker

3.3 / - blocker

3.4 - blocker
3.5 - blocker heart block
3.6 hemodynamic - blocker

- blocker
1.
2.
3.
4.

50 / (systolic BP 90 .)
Heart block second degree AV block trifascicular block

9 - blocker

- blocker
(.)
(./)
Bisoprolol

1.25

2.5,3.75,5,7.5,10

(./)
10

-
Metoprolol *
12.5/ 25
25,50,100,200
200
-
Carvedilol
3.125
6.25,12.5,25,50
50
-
Nebivolol
1.25
2.5,5,10
10
* Metoprolol metoprolol succinate (XL)

20


1. Nitrates
( +,
2)
nitrate nitrate
4-6 ACEI
hydralazine 8-12
2. Hydralazine-Isosorbide dinitrate
ACEI ARB ( +, 1)
2 hydralazine 300 ./ nitrate 160
./ 2

3. Alpha-adrenergic blocker
( -, 2)
4. Calcium antagonists
verapamil diltiazem systolic HF blocker ( -, 3)
5. Calcium antagonist 2 amlodipine felodipine
ACEI
( ++, 1)

21

 left ventricular ejection fraction > 40

Patients with Heart Failure with Preserved LVEF (HF with PLVEF)
20-60%
AF aortic stenosis (AS) obesity
elasticity property compliance
ventricular filling pressure adrenergic receptor peripheral capacity

10
1. Color- Doppler Echocardiogram systolic diastolic function
ventricular relaxation
LV filling pressure cardiac filling pattern loading condition

2. BNP/NTproBNP echocardiogram
10
1.
2.
3.
4. Restrictive (infiltrative) cardiomyopathies amyloidosis, sarcoidosis, hemochromatosis
5. (constrictive pericarditis)
6. Episodic reversible LVSD
7.
8.
9. high output arteriovenous fistulae
10.
11. (atrial myxoma)
12.

22

 PLVEF
++
1. systolic diastolic (
1)
2. AF ( 3)
3. ( 3)
+
1. coronary revascularization PLVEF
myocardial ischemia ( 3)
+/1. AF sinus rhythm ( 3)
2. - blocker, ACEI, ARB, calcium blocker
HF with PLVEF ( 3)
3. digitalis ( 3)

1. digoxin sinus rhythm LVEF > 40
PLVEF
1. ACEI regression LV hypertrophy fibrosis relaxation
distensibility
2. volume depletion
stroke volume cardiac output
3. - blocker diastolic period
4. Nondihydropyridine calcium blockers verapamil diltiazem hypertrophic
cardiomyopathy
5. ARB combined endpoints
(hospitalization)

( , 3)

23


revascularization

1. CABG
2.
3.
3.1 (LV aneurysmectomy)
3.2 Cardiomyoplasty
3.3 Batista operation (partial left ventriculectomy)
3.4 External ventricular restoration
3.5 (heart transplantation)
/ :
1. Cardiac resynchronization therapy (CRT)
2. Implantable cardiovertor defibrillator ( ICD)
3. Cardiac resynchronization therapy and defibrillator (CRT-D)

CABG

left main
LVEF 25% NYHA FC IV

routine management
CABG myocardial viability
stress echocardiography, nuclear myocardial perfusion imaging cardiac magnetic resonance
imaging (off pump coronary revascularization)

severe systolic dysfunction (severe mitral valve insufficiency)

(LV dilatation) (mitral reconstruction)

24

 (LV restoration)
wall tension

left ventricle LV restoration 4
1.
LV aneurysmectomy

2
Cardiomyoplasty
3.
Partial left ventriculectomy (batista operation)
heart transplant ventricular assist device

4.
External ventricular restoration

(heart transplantation):

1. (conventional right ventricular pacing)

2. cardiac resynchronization therapy (CRT)
bi-ventricular pacing
QRS width > 120 ms. (NYHA FC III-IV) CRT

20% severe HF QRS width > 120 ms. inter intraventricular
conduction delay (dys-synchrony)
CRT
CRT 1%
double-blind CRT QRS width >120 ms.

Cardiac resynchronization therapy (CRT)

++
1. CRT
QRS width > 120 ms. (NYHA FC III-IV)
25

 Implantable Cardiovertor Defibrillators (ICD)

++
1. cardiac arrest sustained VT (
1)
2. LVEF < 30-35% ACEI, ARB, - blocker, AA
ICD ( 40 ) ( 1)
++
CRT defibrillator CRT-D NYHA FC III-IV LVEF < 35%,
QRS > 120 ms. ( 2)
+/ 40
(LVEF < 30%) (NYHA FC I) ( 4)
sustained VT VF ICD ICD

MADIT II LVEF < 30%, ICD 31%
controlled trial meta-analysis ICD
primary secondary prevention
ICD (non-cardiac co-morbidity)
NYHA FC IV ICD
dyssynchrony CRT

26

1112
11
1.
1.1.
1.2.
2.
2.1 Cardiovascular reserve functional capacity
2.2
2.2.1 neck vein engorgement crepitation
S3 gallop
2.2.2 orthostatic hypotension
2.3 Perfusion
2.3.1 capillary filling
2.3.2 hypoperfusion - capillary filling
3.
3.1.
3.2. thromboembolic event
3.3. recurrent ischemic event
4.
4.1.
4.2.
4.2.1 ACEI/ARB blocker
4.2.2 aerobic exercise
5.
5.1 compliance non compliance
5.2
5.3
6.
7.
27

 12
1.
1.1
1.2
1.3
1.4
2.
2.1
2.2
2.3
3.
3.1
3.2
3.3
4.
4.1
4.2
4.3
5.
5.1
5.2
5.3
5.4
5.5

28



hypovolemia low
cardiac output

1.
2. 2
1 1-2 ( 2 3 )

2.1 thiazide loop
diuretic furosemide 20 ./ ()
2.2 loop diuretic 1.5 2 (
1 1 )

3-4
2 . 3

(Body mass index (BMI) = 23-24.9 ./2)

(BMI 25 ./2)

cardiac cachexia
5 . 7.5 (non-edematous weight)
6 BMI 18.5 ./2 (
)

2
4


29

 (NYHA FC IV)
2
()

hyponatremia
1.5

alcoholic cardiomyopathy

(aerobic exercise)
peripheral circulation


2-5 1 5-10
isometric exercise 10

1 (8-10 ) (NYHA FC I-II)

sublingual nitrate (
sildenafil ) (NYHA FC III-IV)

2,500
48
( oxygen saturation 92% )
30

 50 1

1.
drug interaction
2. -blocker

3.

4. ( )
drug interaction ( 13)
5.
6.
hypotension


13
1.
2.
3.
4.
5.
6.
7.

NSAID Coxib
Class I antiarrhythmic drug
Calcium channel blocker (verapamil, diltiazem)
Tricyclic antidepressant
Corticosteroid
Lithium
Thiazolidinedione

14

31

 14
Non-Cardiac
1.
2. 13
3.
4.
5.
6.
7.
8.
9.
Cardiac
1. Atrial Fibrillation
2. SVT, ventricular arrhythmias
3.
4.
5.

32

 3
(NYHA FC II-IV)
LVSD
diuretics ACEI

ACEI

Angiotensin Receptor Blocker

(ARB)
inotrope

- blocker

- blocker

- blocker

- blocker
ACEI

- blocker

Aldosterone antagonist (AA)

ACEI
- blocker
- blocker ACEI
acute myocardial
infarction
ACEI, AA ARB
hyperkalemia

Aldosterone antagonist
ARB
digoxin
(
13,14)

- blocker ACEI
ACEI - blocker
33


1. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats GT, et al. ACC/AHA 2005
guidelines update for the diagnosis and management of chronic heart failure in the adult. Circulation
2005;112:e154-e235.
2. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. ESC guidelines for the
diagnosis and treatment of chronic heart failure. Eur Heart J 2005;26:1115-40.
3. Mueller C, Scholer A, Killian KL, Martina B, Schindler C, Buser P, et al. Use of B-type natriuretic peptide
in the evaluation and management of acute dyspnea. N Engl J Med 2004;350:647-54.
4. The digitalis investigation group. The effect of digoxin on mortality and morbidity in patients with heart
failure. N Eng J Med 1997;336:525-33.
5. Ali A, Rich MW, Fleg JL, Zile M, Young JB, Kitzman DW, et al. Effects of digoxin on morbidity and
mortality in diastolic heart failure. Circulation 2006;114:397-403.
6. Adams KF, Gheorghiade M, Uretsky BF, Patterson JH, Schwartz TA, Young JB, et al. Clinical benefits of
low serum digoxin concentrations in heart failure. J Am Coll Cardio 2002;39:946-53.
7. Swedberg K, Held P, Kjekshus J, Rasmussen K, Ryden L, Wedel H. Effects of early administration of
Enalapril on mortality in patients with acute myocardial infarction. N Eng J Med 1992;327:678-84.
8. The acute infarction ramipril efficacy study investigators. Effect of ramipril on mortality and morbidity of
survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet 1993;342:821-28.
9. Kober L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K. A clinical trial of the angiotensin
converting enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial
infarction. N Eng J Med 1995;333:1670-76.
10. Packer M, Wilson PA, Armstrong PW, Cleland J, Horowitz JD, Massie BM, et al. Comparative effects of
low and high doses of the Angiotensin converting enzyme inhibitor, lisinopril, on morbidity and mortality
in chronic heart failure. Circulation 1999;100:2312-8.
11. Cohn JN, Tognoni G, for the Valsartan heart failure trial investigators. A randomized trial of the
Angiotensin receptor blocker Valsartan in chronic heart failure. N Eng J Med 2001;345:1667-75.
12. The OPTIMAAL study group. Effects of Losartan and captopril on mortality and morbidity in high risk
patients after acute myocardial infarction. Lancet 2002;360:752-60.
13. The RALES investigators. The effect of spironolactone on morbidity and mortality in patients with severe
heart failure. N Eng J Med 1999;341:709-17.
14. Pfeffer MA, Swedberg K, Granger CB, Held P, Mcmurray JJ, Michelson EL, et al. Effects of candesartan
on mortality and morbidity in patients with chronic heart failure. Lancet 2003;362:759-66.

34

15. The CIBIS-II investigators and committees. The cardiac insufficiency Bisoprolol study II. Lancet
1999;353:9-13.
16. The MERIT-HF study group. Effect of metoprolol CR/XL in chronic heart failure. Lancet 1999;353:20017.
17. Packer M, Fowler MB, Roecker EB, Coats AJ, Katus HA, Krum H, et al. Effect of carvedilol on the
morbidity of patients with severe chronic heart failure. Circulation 2002;106:2194-9.
18. Aurigemma GP, Gaasch WH. Diastolic heart failure. N Eng J Med 2004;351:1097-105.
19. Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Kocovic DZ, et al. Cardiac
resynchronization in chronic heart failure. N Eng J Med 2002;346:1845-53.
20. Cleland JGF, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac
resynchronization on morbidity and mortality in heart failure. New Engl J Med 2005;352:1539-49.
21. Cleland JGF, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac
resynchronization on morbidity and mortality in heart failure extension phase. Eur Heart J 2006;27:192832.
22. The AVID investigators. A comparison of antiarrhythmics drug therapy with implantable defibrillators in
patients resuscitated from near fatal ventricular arrhythmias. N Engl J Med 1997;337:1557-83.
23. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Lkein H, et al. Improved survival with an
implanted defibrillator in patients with coronary disease at high risk for ventricular arrhymia. N Engl J Med
1996;335:1933-40.
24. Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, Marco T, et al. Cardiac resynchronization
therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med
2004;350:2140-50.

35

AA
ACEI
AF
ARB

Aldosterone antagonist
Angiotension converting enzyme inhibitors
Atrial fibrillation
Angiotensin receptor blocker

AS

Aortic stenosis

AT1
BMI
BNP
CABG
CRT
CRT-D
HF
HF with PLVEF
ICD
LVEF
LVSD
MI
MV
NTproBNP
NYHA FC
PCI
RAS
RAAS
VT

Angiotensin II type I
Body mass index
Brain natriuretic peptide
Coronary artery bypass graft
Cardiac resynchronization therapy
Cardiac resynchronization therapy and defibrillator
Heart failure
Patients with heart failure with preserved LVEF
Implantable cardiovertor defibrillator
Left ventricular ejection fraction
Left ventricular systolic dysfunction
Myocardial infraction
Mitral valve
N-terminal pronatriuretic peptide
New York Heart Association Functional Class
Percutaneous coronary intervention
ReninAngiotensin system
Renin-Angiotensin-Aldosterone system
Ventricular tachycardia

36

37