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左心衰竭是指左心室代償功能不全而發(fā)生的心力衰竭，臨床上極為常見，以肺循環(huán)淤血為主要特征。左心衰竭分為急性左心衰竭和慢性左心衰竭。
慢性左心衰竭（CHF）是大多數(shù)心血管疾病的最終結(jié)果，也是最主要的死亡原因。急性左心衰竭（AHF）是由于突然發(fā)生心臟結(jié)構(gòu)和功能的異常，導(dǎo)致短期內(nèi)心排血量顯著、急劇降低，組織器官灌注不足和急性淤血綜合征。

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In left sided heart failure the left ventricle cannot pump an adequate amount of blood a volume known as preload out of the heart
在左側(cè)心力衰竭中,左心室無法將足夠量的血液(該容量稱為前負荷)泵出心臟·
This condition causes pulmonary congestion
這種情況會導(dǎo)致肺淤血
a buildup of blood in the pulmonary vessels causes fluid in lung tissues that impedes normal respiration
肺血管內(nèi)血液淤積,使液體滲入肺組織,阻礙正常呼吸·
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
收縮性左側(cè)心力衰竭指左心室無法以足夠的收縮力克服稱為后負荷的阻力,將血液泵出心臟輸送至全身·
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
左心室收縮后,心腔內(nèi)殘留的血液會反流入左心房和肺循環(huán),導(dǎo)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
舒張性左側(cè)心力衰竭指左心室無法充分擴張以容納從左心房流入的氧合血液·
In this condition the left ventricle contracts with normal force
在此情況下,左心室收縮力正常,
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滿足身體需求·
Long standing diseases such as coronary artery disease hypertension and diabetes
長期疾病(如冠狀動脈疾病、高血壓和糖尿病)
can thicken and stiffen the ventricular muscle making it a non compliant inefficient pump
可使心室肌增厚、僵硬,導(dǎo)致心室順應(yīng)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
由于心肌收縮力下降,未排出的血液淤積在左心室內(nèi),導(dǎo)致心室腔擴張并肥厚·
This hypertrophy of the heart muscle results in the insufficient delivery of nutrients and oxygen to tissues
這種心肌肥厚會導(dǎo)致組織的營養(yǎng)和氧氣供應(yīng)不足·
In both systolic and diastolic left sided heart failure
在收縮性和舒張性左側(cè)心力衰竭中,
the buildup of unexpelled blood increases pressure in the pulmonary circulation
未排出的血液淤積均會增加肺循環(huán)壓力,
causing serosanguineous fluid to seep into the alveoli and interstitium
導(dǎo)致漿液血性液體滲入肺泡和間質(zhì)·
This fluid buildup is heard as crackles and rhonchi when the lungs are auscultated
肺部聽診時,這種液體潴留可聞及濕啰音和干啰音·
As the lungs saturate with fluid
隨著肺內(nèi)液體潴留加重,
patients may develop difficulty breathing called dyspnea
患者可能出現(xiàn)呼吸困難(稱為 dyspnea)、
trouble breathing while lying flat called orthopnea
平臥時呼吸困難(稱為 orthopnea)
or rapid breathing called tachypnea
或呼吸急促(稱為 tachypnea)·
The heart rate increases to compensate for the left ventricle's weakened state
心率增快以代償左心室的衰弱狀態(tài),
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
隨著時間推移,心肌需費力對抗肺血管壓力升高和肺內(nèi)液體,導(dǎo)致心肌增厚,并持續(xù)心肌損傷的惡性循環(huán)·
Treatment for heart failure involves changes in lifestyle such as diet and exercise medication surgery or a combination of approaches
心力衰竭的治療包括生活方式改變(如飲食和運動)、藥物治療、手術(shù)或綜合治療·
Medications commonly prescribed for heart failure include
心力衰竭常用藥物包括：
diuretics which reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system
利尿劑,通過抑制腎臟腎小管系統(tǒng)對鈉和水的重吸收來減少血容量和靜脈回心血量;
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
血管緊張素轉(zhuǎn)換酶抑制劑(ACEI),通過阻斷腎素 - 血管緊張素 - 醛固酮系統(tǒng)中的激素,擴張血管、降低血容量和靜脈回心血量、減輕心臟負荷并阻止心室肥厚;
digoxin a cardiac glycoside medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations
地高辛,一種強心苷類藥物,通過升高細胞內(nèi)鈉和鈣濃度增強心肌收縮力;
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 受體阻滯劑,與去甲腎上腺素分子競爭心肌細胞上的結(jié)合位點,對抗去甲腎上腺素的作用,降低心肌收縮速率和強度,從而改善全身循環(huán)效率·