【齐读指南】专题二：09年ACC/AHA成人心衰指南——慢性心衰的诊疗部分：Part4：心衰伴随疾病的诊疗建议（5月1日更新，提出您的问题，大家一起思考！）
发布于 2010-02-18 · 浏览 1.4 万 · IP 海南海南
这个帖子发布于 15 年零 108 天前，其中的信息可能已发生改变或有所发展。
提出具体的问题，或许就有了明确的讨论方向！提出自己的疑问，或许才会知道有哪些还没有弄明白！深入思考和讨论，或许会让您更深刻的领会指南！
各位站友可以就：对指南的理解、如何实践指南、甚至是指南未提及的内容等等方面进行深入的探讨！建议结合08年欧洲指南和国内指南。可以提问的方式参与讨论，但最好有针对本问题的自己看法。欢迎参与和切磋！
有本畅销书叫《细节决定成败》，也适用于医学，我们临床医学也无处不讲细节——细节决定健康。应用指南就好像走路，指南在更多的时候只是告诉我们起点和终点，具体怎么走更多得靠自己，每个人（医生或是针对不同病人）可能都有每个人的走法。我想，我们在这里一起来讨论指南的目的，不就是：既要避免盲目追求捷径（欲速则不达），又要避免冤枉走弯路（事倍而功半），去寻找和积累一条稳妥而通畅的路径，通向终点。
==================================Part4=========================================
6. Patients With Heart Failure Who Have Concomitant Disorders (UPDATED)
翻译认领1
Recommendations
CLASS I
1. All other recommendations should apply to patients with concomitant disorders unless there are specific exceptions. (Level of Evidence: C)
2. Physicians should control systolic and diastolic hypertension and diabetes mellitus in patients with HF in accordance with recommended guidelines. (Level of Evidence: C)
3. Physicians should use nitrates and beta blockers for the treatment of angina in patients with HF. (Level of Evidence: B）
4. Physicians should recommend coronary revascularization according to recommended guidelines in patients who have both HF and angina. (Level of Evidence: A)
5. Physicians should prescribe anticoagulants in patients with HF who have paroxysmal or persistent atrial fibrillation or a previous thromboembolic event. (Level of Evidence: A)
6. Physicians should control the ventricular response rate in patients with HF and atrial fibrillation with a beta blocker (or amiodarone, if the beta blocker is contraindicated or not tolerated). (Level of Evidence: A)
7. Patients with coronary artery disease and HF should be treated in accordance with recommended guidelines for chronic stable angina. (Level of Evidence: C)
8. Physicians should prescribe antiplatelet agents for prevention of MI and death in patients with HF who have underlying coronary artery disease. (Level of Evidence: B）
以下为翻译认领2。
CLASS IIa
1. It is reasonable to prescribe digitalis to control the ventricular response rate in patients with HF and atrial fibrillation. (Level of Evidence: A)
2. It is reasonable to prescribe amiodarone to decrease recurrence of atrial arrhythmias and to decrease recurrence of ICD discharge for ventricular arrhythmias. (Level of Evidence: C)
CLASS IIb
1. The usefulness of current strategies to restore and maintain sinus rhythm in patients with HF and atrial fibrillation is not well established. (Level of Evidence: C)
2. The usefulness of anticoagulation is not well established in patients with HF who do not have atrial fibrillation or a previous thromboembolic event. (Level of Evidence: B）
3. The benefit of enhancing erythropoiesis in patients with HF and anemia is not established. (Level of Evidence: C)
CLASS III
1. Class I or III antiarrhythmic drugs are not recommended in patients with HF for the prevention of ventricular arrhythmias. (Level of Evidence: A)
2. The use of antiarrhythmic medication is not indicated as primary treatment for asymptomatic ventricular arrhythmias or to improve survival in patients with HF. (Level of Evidence: A)
各位站友可以就：对指南的理解、如何实践指南、甚至是指南未提及的内容等等方面进行深入的探讨！建议结合08年欧洲指南和国内指南。可以提问的方式参与讨论，但最好有针对本问题的自己看法。欢迎参与和切磋！
有本畅销书叫《细节决定成败》，也适用于医学，我们临床医学也无处不讲细节——细节决定健康。应用指南就好像走路，指南在更多的时候只是告诉我们起点和终点，具体怎么走更多得靠自己，每个人（医生或是针对不同病人）可能都有每个人的走法。我想，我们在这里一起来讨论指南的目的，不就是：既要避免盲目追求捷径（欲速则不达），又要避免冤枉走弯路（事倍而功半），去寻找和积累一条稳妥而通畅的路径，通向终点。
夏的生辰 wrote:其实这个部分基本上已由ouandyin站友在去年做了很好的翻译。故本次更多时候没有了翻译认领，我直接引用了ouandyin的翻译，各位站友可以进行校正和修饰。在这里也感谢ouandyin站友！并追加积分1分。
==================================Part4=========================================
6. Patients With Heart Failure Who Have Concomitant Disorders (UPDATED)
翻译认领1
Recommendations
CLASS I
1. All other recommendations should apply to patients with concomitant disorders unless there are specific exceptions. (Level of Evidence: C)
2. Physicians should control systolic and diastolic hypertension and diabetes mellitus in patients with HF in accordance with recommended guidelines. (Level of Evidence: C)
3. Physicians should use nitrates and beta blockers for the treatment of angina in patients with HF. (Level of Evidence: B）
4. Physicians should recommend coronary revascularization according to recommended guidelines in patients who have both HF and angina. (Level of Evidence: A)
5. Physicians should prescribe anticoagulants in patients with HF who have paroxysmal or persistent atrial fibrillation or a previous thromboembolic event. (Level of Evidence: A)
6. Physicians should control the ventricular response rate in patients with HF and atrial fibrillation with a beta blocker (or amiodarone, if the beta blocker is contraindicated or not tolerated). (Level of Evidence: A)
7. Patients with coronary artery disease and HF should be treated in accordance with recommended guidelines for chronic stable angina. (Level of Evidence: C)
8. Physicians should prescribe antiplatelet agents for prevention of MI and death in patients with HF who have underlying coronary artery disease. (Level of Evidence: B）
以下为翻译认领2。
CLASS IIa
1. It is reasonable to prescribe digitalis to control the ventricular response rate in patients with HF and atrial fibrillation. (Level of Evidence: A)
2. It is reasonable to prescribe amiodarone to decrease recurrence of atrial arrhythmias and to decrease recurrence of ICD discharge for ventricular arrhythmias. (Level of Evidence: C)
CLASS IIb
1. The usefulness of current strategies to restore and maintain sinus rhythm in patients with HF and atrial fibrillation is not well established. (Level of Evidence: C)
2. The usefulness of anticoagulation is not well established in patients with HF who do not have atrial fibrillation or a previous thromboembolic event. (Level of Evidence: B）
3. The benefit of enhancing erythropoiesis in patients with HF and anemia is not established. (Level of Evidence: C)
CLASS III
1. Class I or III antiarrhythmic drugs are not recommended in patients with HF for the prevention of ventricular arrhythmias. (Level of Evidence: A)
2. The use of antiarrhythmic medication is not indicated as primary treatment for asymptomatic ventricular arrhythmias or to improve survival in patients with HF. (Level of Evidence: A)
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