WordNet

lack of success; "he felt that his entire life had been a failure"; "that year there was a crop failure"
loss of ability to function normally; "kidney failure"
an act that fails; "his failure to pass the test"
an unexpected omission; "he resented my failure to return his call"; "the mechanics failure to check the brakes"
a person with a record of failing; someone who loses consistently (同)loser, nonstarter, unsuccessful person
an event that does not accomplish its intended purpose; "the surprise party was a complete failure"
of or relating to a diastole or happening during a diastole

PrepTutorEJDIC

〈U〉(…における)『失敗』,不成功《+『in』+『名』(do『ing』)》 / 〈C〉失敗者,落後者;失敗した企て,不できなもの / 〈U〉〈C〉怠慢,不履行 / 〈U〉〈C〉(…の)不足,欠乏《+『of』+『名』》 / 〈U〉〈C〉(…の)破産《+『of』+『名』》 / 〈U〉(…の)『衰弱』,減退《+『in』(『of』+『名』》

UpToDate Contents

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1. Treatment and prognosis of heart failure with preserved ejection fraction
2. 拡張期心不全の臨床症状および診断 clinical manifestations and diagnosis of diastolic heart failure
3. 拡張期心不全の病態生理 pathophysiology of diastolic heart failure
4. Preanesthesia evaluation for cardiac surgery
5. 心不全の予後 prognosis of heart failure

English Journal

Association between omentin and echo parameters in patients with chronic heart failure.

Jiang H1, Zhao G, Li X, Jin H, Yang G, Jin K, Piao L, Zhu E, Lei Y, Fang E, Han X, Nan Y, Jin Q, Cheng X.
Minerva cardioangiologica.Minerva Cardioangiol.2017 Feb;65(1):8-15. Epub 2016 Jun 8.
BACKGROUND: Adipose-derived adipokines have been demonstrated to be associated with the development of experimental heart disease through chronic inflammation and cardiac cell apoptosis. Omentin is to be one of the novel adipokines. The aim of this study is to investigate the relationship between ci
PMID 27270246

Impact of Iron Deficiency on Response to and Remodeling After Cardiac Resynchronization Therapy.

Martens P1, Verbrugge F2, Nijst P1, Dupont M2, Tang WH3, Mullens W4.
The American journal of cardiology.Am J Cardiol.2017 Jan 1;119(1):65-70. doi: 10.1016/j.amjcard.2016.09.017. Epub 2016 Sep 29.
Iron deficiency is prevalent in heart failure with reduced ejection fraction and relates to symptomatic status, readmission, and all-cause mortality. The relation between iron status and response to cardiac resynchronization therapy (CRT) remains insufficiently elucidated. This study assesses the im
PMID 27780556

Classification and Prognostic Evaluation of Left Ventricular Remodeling in Patients With Asymptomatic Heart Failure.

Pugliese NR1, Fabiani I2, La Carrubba S3, Conte L2, Antonini-Canterin F4, Colonna P5, Caso P6, Benedetto F7, Santini V2, Carerj S8, Romano MF9, Citro R10, Di Bello V2; Italian Society of Cardiovascular Echography (SIEC).
The American journal of cardiology.Am J Cardiol.2017 Jan 1;119(1):71-77. doi: 10.1016/j.amjcard.2016.09.018. Epub 2016 Sep 29.
Patients with asymptomatic heart failure (HF; stage A and B) are characterized by maladaptive left ventricular (LV) remodeling. Classic 4-group classification of remodeling considers only LV mass index and relative wall thickness as variables. Complex remodeling classification (CRC) includes also LV
PMID 27776801

Japanese Journal

Predictors and Clinical Impacts of Aggravated Left Ventricular Diastolic Dysfunction After Off-Pump Coronary Artery Bypass Grafting

Circulation journal : official journal of the Japanese Circulation Society 80(9), 1937-1945, 2016-09
NAID 40020915980

核医学画像と解析の標準化

臨床放射線 61(9), 1115-1126, 2016-09
NAID 120005895694

新規強心薬SCH00013のモルモット心臓に対する作用

名古屋学院大学論集. 人文・自然科学篇 = Journal of Nagoya Gakuin University 53(1), 23-33, 2016-07
NAID 120005832957

「心不全」

　　[★]

英: heart failure, HF, cardiac failure CF, cardiac insufficiency
関

定義

心臓のポンプ能が低下しているために、十分な心拍出量が得られない状態を指す (EPT.115)
心筋の機能が低下し、末梢組織の酸素需要量に見合うだけの血液を駆出できなくなった状態。
心臓に器質的あるいは機能的異常が生じて、心臓のポンプ機能力が低下し、主要臓器の酸素需要量に見合うだけの血液を拍出できない病態(YN)。全ての心疾患の「終末像」である。あくまでも終末像のため、死亡診断書に死因と記載するのは不適切である。

分類

病期

原因

収縮不全 systolic failure: HF with a depressed EF
拡張不全 diastolic failure: HF with a preserved EF

場所

病態の分類

病期分類

http://www.abouthf.org/questions_stages.htm
Class I (Mild)

No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea (shortness of breath).

Class II (Mild)

Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea.

Class III (Moderate)

Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea.

Class IV (Severe)

Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased.

原因

虚血性心疾患、弁膜疾患、高血圧精神疾患、心筋虚血の順に多い。(IMD.790)
誘因としては過労、ストレス、感染、心拍数の異常、不整脈、水分・塩分の過剰摂取がある。

増悪因子

ストレス
感染症：頻脈→心筋酸素需要↑
貧血　：心拍出量↑
妊娠　：心拍出量↑、体液量↑
甲状腺機能亢進症：甲状腺ホルモン(心臓のカテコラミン受容体増加)の陽性変力効果、陽性変時効果→心筋酸素需要↑
血圧上昇　：圧負荷
頻脈性不整脈：心筋酸素需要↑

table 9.3. 代償されている心不全において症状を誘発させる要因 PHD.240

代謝的需要の増加　→　心筋が十分に収縮できなくなる

発熱
感染症
貧血
頻脈
甲状腺機能亢進症
妊娠

循環血液量の増加　→　前負荷の増加

過剰の塩分摂取
過剰の水分摂取
腎不全

後負荷を増加させる状態

コントロールされていない高血圧　←左心系
肺塞栓症　←　右心系

心収縮力を低下させる状態

陰性変力作用を持つ薬物
心筋虚血 or 心筋梗塞
アルコールの摂取

心不全の薬の飲み忘れ
極端な徐脈

症状

左心不全	右心不全
労作時呼吸困難	経静脈怒張
発作性夜間呼吸困難	肝肥大
起坐呼吸	下腿浮腫
肺水腫	胸水
肺うっ血	腹水
湿性ラ音
チェーンストークス呼吸

心不全の身体所見 IMD.791改変

	右心不全	左心不全
	後方障害	前方障害	後方障害
自覚症状	体重増加	易疲労感	労作時息切れ
	食思不振	食思不振	夜間呼吸困難
	浮腫	動悸	浅眠
	腹満感	乏尿	動悸
他覚症状	浮腫	頻脈	起座呼吸
	肝腫大	冷汗	喘鳴
	頚静脈怒張	皮膚蒼白	泡沫痰
	腹水	チアノーゼ	血痰
	黄疸	乏尿・無尿	チアノーゼ
	チアノーゼ	血圧低下	肺野ラ音
		不穏	胸水
		意識低下
心臓の身体所見	心拡大、P2亢進	心拡大、S3亢進、奔馬調律、機械的交互脈、僧帽弁閉鎖不全症、頻脈、脈圧低下

急性期症状		慢性期症状