Heart failure cardiologists called malignant state. But it turns out, is not so pessimistic
- Patients with chronic heart failure, more and more, and it is ironic due to the successes of medicine, - says Yuri Belenkov, corresponding member of Russian Academy of Sciences, Academician and Vice-Rector of Moscow State University. Lomonosov . - Before dying of heart attacks, arrhythmias, defects and other severe heart disease. We learned how to treat them, and now these patients live a long time and with good quality of life. But over time, the heart begins to pump blood is worse - this is heart failure. More 10-15 years ago, everything was bad, we could not treat these patients effectively.
It became clear in 2001 after a huge study in which more than 400 doctors surveyed 23, 5 thousand. Patients in 10 regions of Russia. It turned out that the country's 8, 1 million patients with overt heart failure and 3 of them, 5 million had been the final stage of the disease. Male life expectancy after diagnosis was only 3, 2 years, and women - 5, 3 years. For the year in the country kills about 900 thousand. Such patients.
10 years later
- More than ten years, we have purposefully introduce modern methods of diagnosis and treatment of heart failure, - says Vyacheslav Mare, professor, vice-rector of Moscow State University Deputy . - They taught that doctors and social workers, and patients and their families explained how to control this condition, how to live with him, work, travel and even how to keep sexual activity. Implementation of patient education and control of post-discharge reduced the risk of readmission by 38% and significantly reduce the cost of treatment. As a result, the risk of death decreased by 47%, and it is 5-7 years of life, and the life of good quality. For this work, a group of scientists in 2010 won the Russian Government.
Addition of special exercises to treatment reduces mortality by 18%, and repeated hospitalizations - by 32%. And more recently these patients exercise strictly limited. Helped and high technology. It was first introduced in practice of a special pacemaker. It enforces the proper heart rhythm and starts it if "motor" stops. Similar devices are used for a long time, but in heart failure they often complicate the situation.
- This is due to the fact that such patients are often abbreviated ventricles not simultaneously, and it enhances cardiac failure, - explains Vyacheslav Mareev. - The new device makes the ventricles to contract at the same time. It not only protects against fatal arrhythmias, but also improves the functioning of the heart as a pump. As a result, a 37% reduced risk of death in the most severe patients. More than ten years of living 90% of them, while conventional pacemakers - only 67%. In Russia, such pacemakers are already installed in 22 centers. They treat patients from all regions of Russia. But, unfortunately, they are used by only 0, 8% of patients with heart failure, and in Europe - is 15-16%.
Science - practice
- Included in the daily practice of the artificial left ventricle, - says Yuri Belenkov. - He used to be cumbersome, it was created to the patient could not wait donor heart, but now has become almost a miniature, it is set via the endoscope without incisions. Live with him for 3-5 years. During this time the condition of the heart often improves. More and more use of shock-wave therapy, it stimulates the growth of new blood vessels and the heart is best reduced. Not far off the stem cell therapy. Drinking it is ambiguous, and scars from it not dissolve, but it strengthens the heart, stimulating the formation of muscle cells. From stem cells to grow heart valves soon be for transplant. So most malignant disease of the heart, we will win.
BTW
How not to miss chronic heart failure (CHF), says Yuri Vasiuk, Honored Doctor of the Russian Federation, professor, vice-rector on medical work MSMSU:
- It is important to identify heart failure at an early stage. On her presence nonspecific signs saying: causeless weakness, fatigue, shortness of breath sometimes light at light load. Previously, the diagnosis was made when there were edema and dyspnea, but it was too late. Particularly attentive to these signs need to be patient with:
■ hypertension, coronary heart disease and a combination thereof;
■ obstructive bronchitis and bronchial asthma;
■ diabetes;
■ alcohol abuse (CHF them arises from the alcoholic cardio-myopathy).
All of these patients is very important to get vaccinated against the flu: the infection stimulates and strengthens the CHF every 4th patient. It is important to treat patients even with a minimum of CHF, or those to whom it is only threatened.
To do this:
1. Reduce the pressure to normal levels.
2. Taking drugs that make the pulse more rare (many of them were previously contraindicated in CHF).
3. Take medications to protect the vascular wall and preventing the formation of blood clots.
4. To deal with risk factors - smoking, obesity, poor diet, physical inactivity.
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