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Insuficiência cardíaca Otimização do tratamento clínico

Insuficiência cardíaca Otimização do tratamento clínico. Como obter o máximo do bloqueio neurohormonal? Joel Pinho Prof. da Escola Bahiana de Medicina Coordenador do Ambulatório de IC do Hospital Santa Izabel. Ativação Neurohormonal em Pacientes com Ins. Cardíaca (SOLVD ). Estudo RESOLVD.

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Insuficiência cardíaca Otimização do tratamento clínico

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  1. Insuficiência cardíacaOtimização do tratamento clínico Como obter o máximo do bloqueio neurohormonal? Joel Pinho Prof. da Escola Bahiana de Medicina Coordenador do Ambulatório de IC do Hospital Santa Izabel

  2. Ativação Neurohormonal em Pacientes com Ins. Cardíaca (SOLVD)

  3. Estudo RESOLVD 17 43 Circulation 1999;100:1056-1064

  4. Estudo RESOLVD Circulation 1999;100:1056-1064

  5. The CHARM-Overall programme Lancet 2003 362: 759–66

  6. Permanent study-drug discontinuations for adverse events – CHARM-ADDED TRIAL Lancet 2003; 362: 767–71.

  7. B-type natriuretic peptide levels before and after treatment in relation to end points. J Am Coll Cardiol 2001;37:386 –91)

  8. ADHERE J Am Coll Cardiol 2007;49:1943–50

  9. J Am Coll Cardiol 2007;49:1943–50

  10. The STARS-BNP J Am Coll Cardiol 2007;49:1733–9

  11. J Am Coll Cardiol 2007;49:1733–9

  12. Event-Free (Hospital Stay for Heart Failure or DeathRelated to Heart Failure) Survival in the 2 Groups J Am Coll Cardiol 2007;49:1733–9

  13. Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin II Receptor Blocker (ARB) and -Blocker Doses During the Study (TIME-CHF) TIME-CHF) JAMA. 2009;301(4):383-392

  14. TIME-CHF) JAMA. 2009;301(4):383-392

  15. TIME-CHF) JAMA. 2009;301(4):383-392

  16. TIME-CHF JAMA. 2009;301(4):383-392

  17. TIME-CHF JAMA. 2009;301(4):383-392

  18. Treatment Effects on Main Outcomes in Younger Compared With Older Patients

  19. III Diretriz Brasileira de Insuficiência Cardíaca Crônica 2009

  20. Para se obter o máximo efeito terapêutico sobre a ativação neurohormonal, devemos usar os fármacos indicados em conjunto, nas doses preconizadas pelos grandes estudos. A dosagem de BNP para avaliação da resposta neurohormonal, ao tratamento clínico, ainda carece de validação em estudos prospectivos e com número grande de pacientes.

  21. III Diretriz Brasileira de Insuficiência Cardíaca Crônica 2009

  22. Arch Intern Med. 2006;166:315-320

  23. X

  24. The relation between end points and rising versus falling BNP levels during treatment J Am Coll Cardiol 2001;37:386 –91

  25. J Am Coll Cardiol 2007;49:1943–50

  26. Evolução Terapêutica na Insuficiência Cardíaca

  27. Alternate pathways Chymases Cathepsin G

  28. Cathepsin G Elastase

  29. Val-HeFT N Engl J Med 2001;345:1667-75

  30. VALIANT N Engl J Med 2003;349:1893-906.

  31. RALES NEJM 1999;341:709-17

  32. Kaplan–Meier Estimates of the Rate of Death from Any Cause EPHESUS NEJM 2002;348:1309-21

  33. Experiência inicial com B-bloqueadores na ICC • Waagstein et al Br Heart J 1975;37:1022-36 • Swedberg et al Br Heart J 1980;44:117-133 • Swedberg et al Br Heart J 1980;44:134-142

  34. VA Medical Center Am Heart J 2007;153:515-22

  35. Am Heart J 2007;153:515-22

  36. Carvedilol and Morbidity and Mortality in Chronic Heart Failure - U.S. CARVEDILOL Packer et al NEJM 1996; 334:1349-55

  37. Am Heart J 2007;153:515-22

  38. MOCHA Bristow et al Circulation 1996,94:2807-16 MOCHA

  39. X

  40. J Am Coll Cardiol 2007;49:1733–9

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