左心衰竭是指左心室代偿功能不全而发生的心力衰竭,临床上极为常见,以肺循环淤血为主要特征。左心衰竭分为急性左心衰竭和慢性左心衰竭。
慢性左心衰竭(CHF)是大多数心血管疾病的最终结果,也是最主要的死亡原因。急性左心衰竭(AHF)是由于突然发生心脏结构和功能的异常,导致短期内心排血量显著、急剧降低,组织器官灌注不足和急性淤血综合征。

In left sided heart failure the left ventricle cannot pump an adequate amount of blood a volume known as preload out of the heart.
在左侧心力衰竭中,左心室无法将足够量的血液(该容量称为前负荷)泵出心脏·
This condition causes pulmonary congestion
这种情况会导致肺淤血
a buildup of blood in the pulmonary vessels causes fluid in lung tissues that impedes normal respiration.
肺血管内血液淤积,使液体渗入肺组织,阻碍正常呼吸·
Systolic left sided heart failure describes the left ventricle's inability to contract with enough force to drive blood out of the heart against resistance called afterload to the rest of the body.
收缩性左侧心力衰竭指左心室无法以足够的收缩力克服称为后负荷的阻力,将血液泵出心脏输送至全身·
After a left ventricular contraction the blood left behind in the chamber causes blood to back up into the left atrium and pulmonary circulation leading to pulmonary congestion.
左心室收缩后,心腔内残留的血液会反流入左心房和肺循环,导致肺淤血·
Diastolic left sided heart failure describes the inability of the left ventricle to expand sufficiently to accommodate oxygenated blood entering from the left atrium.
舒张性左侧心力衰竭指左心室无法充分扩张以容纳从左心房流入的氧合血液·
In this condition the left ventricle contracts with normal force
在此情况下,左心室收缩力正常,
but the blood volume that is pumped out is insufficient to meet the body's needs.
但泵出的血量不足以满足身体需求·
Long standing diseases such as coronary artery disease hypertension and diabetes
长期疾病(如冠状动脉疾病、高血压和糖尿病)
can thicken and stiffen the ventricular muscle making it a non compliant inefficient pump.
可使心室肌增厚、僵硬,导致心室顺应性下降、泵血效率降低·
As a result of reduced myocardial contractility the unexpelled blood pools inside the left ventricle and the chamber expands to hypertrophic size.
由于心肌收缩力下降,未排出的血液淤积在左心室内,导致心室腔扩张并肥厚·
This hypertrophy of the heart muscle results in the insufficient delivery of nutrients and oxygen to tissues.
这种心肌肥厚会导致组织的营养和氧气供应不足·
In both systolic and diastolic left sided heart failure
在收缩性和舒张性左侧心力衰竭中,
the buildup of unexpelled blood increases pressure in the pulmonary circulation
未排出的血液淤积均会增加肺循环压力,
causing serosanguineous fluid to seep into the alveoli and interstitium.
导致浆液血性液体渗入肺泡和间质·
This fluid buildup is heard as crackles and rhonchi when the lungs are auscultated.
肺部听诊时,这种液体潴留可闻及湿啰音和干啰音·
As the lungs saturate with fluid
随着肺内液体潴留加重,
patients may develop difficulty breathing called dyspnea
患者可能出现呼吸困难(称为 dyspnea)、
trouble breathing while lying flat called orthopnea
平卧时呼吸困难(称为 orthopnea)
or rapid breathing called tachypnea.
或呼吸急促(称为 tachypnea)·
The heart rate increases to compensate for the left ventricle's weakened state
心率增快以代偿左心室的衰弱状态,
which in time leads to thickening the myocardium as it labors to push blood out of the heart against the increasing pressure in the pulmonary vessels and fluid in the lungs and continuing the cycle of cardiac muscle damage.
随着时间推移,心肌需费力对抗肺血管压力升高和肺内液体,导致心肌增厚,并持续心肌损伤的恶性循环·
Treatment for heart failure involves changes in lifestyle such as diet and exercise medication surgery or a combination of approaches.
心力衰竭的治疗包括生活方式改变(如饮食和运动)、药物治疗、手术或综合治疗·
Medications commonly prescribed for heart failure include
心力衰竭常用药物包括:
diuretics which reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system
利尿剂,通过抑制肾脏肾小管系统对钠和水的重吸收来减少血容量和静脉回心血量;
ACE inhibitors which block hormones in the renin angiotensin aldosterone system dilating vessels lowering blood volume and venous return decreasing the heart's workload and halting ventricular hypertrophy
血管紧张素转换酶抑制剂(ACEI),通过阻断肾素 - 血管紧张素 - 醛固酮系统中的激素,扩张血管、降低血容量和静脉回心血量、减轻心脏负荷并阻止心室肥厚;
digoxin a cardiac glycoside medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations
地高辛,一种强心苷类药物,通过升高细胞内钠和钙浓度增强心肌收缩力;
and beta blockers which compete with norepinephrine molecules for binding sites on cardiomyocytes preventing norepinephrine's effects resulting in reduced speed and strength of the contractions which can support more efficient circulation through the body.
β 受体阻滞剂,与去甲肾上腺素分子竞争心肌细胞上的结合位点,对抗去甲肾上腺素的作用,降低心肌收缩速率和强度,从而改善全身循环效率·
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