27_scompenso cardiaco optimized

7/25/2019 27_Scompenso Cardiaco Optimized

1/10

Ekgus

WGKL]DAWK GHÔCHGK Bdhrt ehcfurd@hnrcdffh Od ^ksh, Lhaudfh ]hrodk

ODECACYCKAD

Fk sgklpdask ghrochgk, odactk gkld fcaghphgct odf gukrd h lhatdadrduah ctthth hodùhth hffd dsc`dazd ldthnkfcgbd odffkr`hacslk, gkasd-ùdazh oc ua `ruppk dtdrk`dadk oc phtkfk`cd hagbd aka prclctcvhldatdghrochgbd gbd prkvkghak uahftdrhzckad oc uak k pc odtdrlcahatc odffh`ctthth ghrochgh9 prdghrcgk:

pkstghrcgk: gkatrhttcfct: erdqudazh ghrochgh.

GHTWD D CAGCODAYH

Ca dt houfth fk sgklpdask ghrochgk lkftk spdssk sdgkaohrck h phtkfk-`ch csgbdlcgh: ca dt pdochtrcgh, cavdgd, fd ghusd prcagcphfc skak9 ocedttcgka`dactc gbd odtdrlcahak ua skvrhgghrcgk oc prdssckad d/k oc vkfuld,ghrocklckphtcd `dadtcghldatd odtdrlcahtd k hgqucsctd, ocseuazckad lck-ghrocgh sdgkaohrch ho catdrvdatc ghrockgbcrur`cgc. Fcagcodazh haauhfd odffk =,7? 8==.=== nhlncac.Fd ghrockphtcd gka`dactd skak fd rdspkashncfc odffh lh``ckr phrtd odcghsc oc casuegcdazh ghrochgh ca dt pdochtrcgh. Fcagcodazh oc sgklpdaskghrochgk ca thfd ehsgch oc phzcdatc vh ohffk =.8% hffk =.>%.C ocedttc ghrochgc gka skvrhgghrcgk oc vkfuld gkld cf ocedttk catdrvda-trcgkfhrd (OCU) do cf ghahfd htrck-vdatrcgkfhrd (GHU), skak fd ghusd pcerdqudatc adc prclc 5 ldsc oc vcth.Fcagcodazh odffd ghrocklckphtcd ocegcfd oh odtdrlcahrd skprhttuttk pdrfh fkrk dtdrk`dacgct dzckfk`cgh ( rcpkrthth suf rd`cstrk hldrcghak odffdghrocklckphtcd uacagcodazh oc =.5 ghsc pdr 8==.=== nhlncac).

Wgkaksgcuth fcagcodazh odffk sgklpdask ghrochgk sdgkaohrck ho ca-tdrvdatk ghrockgbcrur`cgk.Fdpkgh oc gklphrsh odffcasuegcdazh ghrochgh vhrch ca rhppkrtk hf tcpkoc phtkfk`ch skttksthatd.


2/10

Ahsgcth Ghrockphtcd gka`dactd

Lhfhttch oc Dnstdca

Hlpch ecstkfh hrtdrkvdaksh scstdlcgh

Ocseuazckad odf lusgkfk ghrochgk

Hsecssch, sdpsc, cpk`fcgdlch, cpkghfgdlch

Haklhfcd dlhtkfk`cgbd

Hadlch, scaorkld oh cpdrvcsgksct

Hrctlcd

Nfkggk htrck-vdatrcgkfhrd (NHU), thgbcghroch phrksscstcgh

skprhvdatrcgkfhrd (_]WU)

Ahsgcth-8sdttclhah Ghrockphtcd gka`dactd

Gukrd scacstrk cpkpfhscgk, gkhrthzckad hkrtcgh, htrdsch

hkrtcgh, stdaksc pkflkahrd grctcgh, rctkrak vdakskpkflkahrd haklhfk tkthfd (Û]H_) gka kstruzckad,

okttk hrtdrcksk pdrvck (]OH) adf prdlhturk

Ocseuazckad odf lusgkfk ghrochgk d hrctlcd

]htkfk`cd daokgrcad d rdahfc

Casueecgcdazh gkrtcgksurrdahfd

Casueecgcdazh rdahfd

Oh 8 h 5 sdttclhad Ghrockphtcd gka`dactd

Hlpck OCU, ]OH, GHU, truagus, Û]H_ aka kstructk,kstruzckac scacstrd

Krc`cad haklhfh odffh gkrkahrch sa ohffhrtdrch pkflkahrd

Haklhfcd lusgkfk ghrochgk

Ghrocklckphtcd

Lckghroctd

Oh 5 sdttclhad h 5 ldsc Hlpck OCU, ]OH, GHU

Okpk c 8> ldsc fk sgklpdask ghrochgk ldak erdqudatd d fd ghusdprcagcphfc skak9 hrctlcd: lckghroctd: ghrockphtcd hgqucsctd (ghroctd rdulhtcgh, lhfhttch oc Jhwhshjc): ghrocklckphtcd: ocseuazckad lckghrocgh sdgkaohrch ho catdrvdatk ghrockgbcrur`cgk.

ECWCK]H_KFK@CH

Caocpdaodatdldatd ohf ldgghacslk dzckfk`cgk, fcasuegcdazh ghroch-

gh odtdrlcah uah `ctthth ghrochgh cahodùhth hffd dsc`dazd tcssuthfc. Wccasthurhak hfguac ldgghacslc gklpdashtkrc gbd hffh fua`h pktdazchakd pd``ckrhak fk sgklpdask ghrochgk. C ldgghacslc gklpdashtkrc skak


3/10

rhpprdsdathtc dssdazchfldatd ohffhttcvhzckad adurk-krlkahfd d ohffc-pdrtrkh lckghrocgh.Fhttcvhzckad odf scstdlh sclphtcgk hutkaklk d odf scstdlh rdacah ha-

`cktdascah prkvkghak deedttc hordadr`cgc gka vhskgkstrczckad pdrcedrcghd rctdazckad corkshfcah. Cf rcfhsgck oc ghtdgkfhlcad odtdrlcah ua huldatkodffh ekrzh gkatrhttcfd, lh sekrtuahthldatd fh vhskgkstrczckad pdrcedrcghprkvkgh ua huldatk odf pkst-ghrcgk d qucaoc odf fhvkrk vdatrcgkfhrdksthgkfhaokad fk svukthldatk.Fcpdrtrkh gklpdashtkrch huldath fh ghphgct gkatrhttcfd lh gkaougdprk`rdsscvhldatd ho ua hftdrhtk rcfhsgchldatk ochstkfcgk._uttc qudstc dvdatc prkvkghak h fua`k haohrd gka`dstckad vdaksh scstd-lcgh d pkflkahrd.Fh nhsd lkfdgkfhrd odffk sgklpdask ghrochgk rhpprdsdathth ohffd hftd-rhzckac odffhpkptksc, ldgghacslk dadtcghldatd odtdrlcahtk odstcahtkhffh ocstruzckad oc gdffufd ohaad``chtd. Fhttcvhzckad adurk-krlkahfd,prdsdatd ca tuttc c phzcdatc gka ocseuazckad vdatrcgkfhrd scacstrh, httcvhfhpkptksc gka fcndrhzckad oc dazclc prktdkfctcgc rdspkashncfc odffh adgrksclckghrocgh. _hfd prkgdssk rdvdrscncfd ak h gbd fhpkptksc aka cathgghcf augfdk gdffufhrd.Fh sgklphrsh odffhttcvhzckad adurk-krlkahfd, gbd sc pu httuhrd gka fhtdrhpch gka n-nfkgghatc do HGD-cacnctkrc, do cf rclkodffhldatk vdatrc-gkfhrd, pksscncfd okpk fh ghrockgbcrur`ch, pksskak gkaourrd h rdgupdrkgdffufhrd.

GH^H__D^CW_CGBD GFCACGBD

Fk sgklpdask ghrochgk pu gklphrcrd h quhfschsc dt, tutthvch c nhl-ncac hf oc skttk oc ua haak rhpprdsdathak gcrgh cf 3=% oc tuttc c phzcdatcpdochtrcgc. C sd`ac do c scatklc skak ghushtc ca phrtd ohffh rcouzckadodffh `ctthth ghrochgh do ca phrtd ohffh prdsdazh oc gka`dstckad vdakshscstdlcgh d pkflkahrd.

Wcatklc d sd`ac

Adkahtk d fhtthatd9 ocegkft hfcldathrc, rcthrok oc grdsgcth, thgbcpadhgbd pd``ckrh gka fhfcldathzckad, thgbcghroch (1 85= npl adf skaak),rctlk oc `hfkppk, pkfsc odnkfc, gutd erdooh, tdlpk oc rdff ghpcffhrd

prkfua`htk, suokrhzckad, dphtkld`hfch. Nhlncak9ocspadh oh sekrzk, thgbcpadh gka rcdatrhldatc catdrgksthfc,rhatkfc ac grdpcthatc, ehgcfd heehtcghncfct, tkssd k ahusdh, thgbcghroch(1 8== npl), dphtkld`hfch, rhrc `fc dodlc pdrcedrcgc gks gkld fh


4/10

ocstdasckad odffd vdad odf gkffk, sghrsk hppdtctk do hrrdstk oc grdsgcth.Ad`fc hokfdsgdatc pksskak dssdrd prdsdatc cakftrd krtkpadh, ocspadhaktturah d scatklc `hstrkcatdstcahfc.

Adffh prhtcgh gfcacgh sc rcgkrrd hffh gfhssceghzckad oc ^ksspdr vhfuthrdfh sdvdrct odffk sgklpdask ghrochgk9

GFHWWD C Hscatklhtcgc.

GFHWWD CC Adkahtc9 fcdvd thgbcpadh, suokrhzckad ourhatd c phstc. Nhlncac9 ocspadh oh sekrzk.

GFHWWD CCC Adkahtc9 lhrghth thgbcpadh, suokrhzckad ourhatd c phstc,prkfua`hldatk odffh ourhth odf phstk, hrrdstk oc grdsgcth.

Nhlncac9 lhrghth ocspadh oh sekrzk.

GFHWWD CU _hgbcpadh, rcdatrhldatc catdrgksthfc, suokrhzckad, rua-tca` h rcpksk.

OCH@AKWC

Fh ochàksc oc sgklpdask ghrochgk uah ochàksc dssdazchfldatd gfcacghca guc fh vhfuthzckad fhnkrhtkrcstcgh d struldathfd skfk oc skstdàk.

^x tkrhgd9dvcodazch ghrockld`hfch d cagrdldatk odffh trhlh vhsgkfhrd.Fh ghrockld`hfch sdlprd prdsdatd trhaad gbd adffd kstruzckac hf odusskvdaksk pkflkahrd gkld fh stdaksc lctrhfcgh k cf Û]H_ kstructk.

DG@9 aka ochàkstcgk oc sgklpdask ghrochgk, lh oc skstdàk adffhvhfuthzckad dzckfk`cgh (hrctlcd).

Dgkghrock`rheh9pdrldttd fh vhfuthzckad odffd ghldrd ghrochgbd, od-`fc caocgc oc euazckahfct scstk-ochstkfcgh d gkasdatd oc lkactkrczzhrd fhtdrhpch.

Dshlc dlhtkgbclcgc9 spdssk prdsdatd uah fcdvd hadlch: c tdst oc eua-zckahfct rdahfd dvcodazchak uah rcouzckad odf ftrhtk `fkldrufhrd dodfdvhzckad odc fcvdffc oc grdhtcacah adf shaùd. Adf sdocldatk urcahrck

pksskak dssdrd prdsdatc prktdcaurch do dlhturch lcgrksgkpcgh.


5/10

]^K@AKWC

Fh ghush prcagcphfd oc sgklpdask ghrochgk ca dt pdochtrcgh rhpprd-

sdathth ohc ocedttc gka`dactc, fh lh``ckr phrtd odc quhfc gkrrd``cncfcgbcrur`cghldatd. Fh prkàksc ca thfd ghtd`krch oc phzcdatc strdtthlda-td gkaadssh hf tcpk oc ghrockphtch gka`dacth. ]urtrkppk pdr fd ekrld ocsgklpdask ghrochgk sdgkaohrcd h ghrocklckphtcd prclctcvd k sdgkaohrcdfh prkàksc hagkrh pkgk cagkrh``chatd9 fh lkrthfct h 4 haac rclhadcaehttc odff2=%.

_D^H]CH

Cf phzcdatd odvd dssdrd kspdohfczzhtk pkcgb fk sgklpdask ghrochgk uah gkaoczckad pktdazchfldatd fdthfd d odvd dssdrd caczchtk hf pc prdstkcf fhvkrk ochàkstcgk vkftk h sthncfcrd fh ghush pdr pktdrfh rclukvdrd.@fc kncdttcvc odffh tdrhpch skak9 rclkzckad odffh phtkfk`ch skttksthatd: gkatrkffk odffcasuegcdazh ghrochgh.Fdfclcahzckad odffh ghush dadrhfldatd fhpprkggck lc`fckrd d spdsskca dt pdochtrcgh gkascstd adffh gkrrdzckad gbcrur`cgh oc ua ocedttk gka-`dactk k adf trhtthldatk ldocgk oc uah spdgcgh gkaoczckad gkld uahsdpsc k uah sdvdrh cpdrtdasckad k hadlch.Cf gkatrkffk odffcasuegcdazh prdvdod9 fh rcouzckad odffh rctdazckad corcgk-shfcah: fh lkoufhzckad odffd haklhfcd adurk-krlkahfc: fhuldatk odffh gkatrhttcfct lcghrochgh.

Lcsurd `dadrhfc

]ksczckad sdouth h 7= pdrgb rcougd fh gka`dstckad vdaksh pkflkahrd.

Huldatk odffhppkrtk oc kssc`dak (oh dvcthrd ca prdsdazh oc ghrockphtcdgka`dactd okttk ocpdaodatc). Lhatdacldatk odffh tdlpdrhturh gkrpkrdh adc rha`d oc akrlhfct. ^couzckad odf gkasulk oc kssc`dak trhlctd sdohzckad (adc phzcdatc

h`cthtc), dfclcahzckad oc caedzckac d ednnrd. Hfcldathzckad9 sc gkasc`fch lh``ckrd erhzckahldatk odc phstc do dvda-

tuhfd usk oc catd`rhtkrc fugcocgc d fcpcocgc pdr huldathrd cf gkatdautk

ghfkrcgk odf phstk sdazh huldathrad cf vkfuld. Adc ghsc pc `rhvc scprdedrcsgd fhfcldathzckad trhlctd skaocak ahsk-`hstrcgk. Fhppkrtkcorcgk ca ehsd caczchfd odvd dssdrd oc 54 lf/j`/ocd.

Gkrrdzckad oc dvdatuhfd hadlch.


6/10

Lcsurd spdgcegbd

C ehrlhgc oh utcfczzhrd, fd lkohfct, fh oksd d fh vch oc skllcacstrhzckad

vhaak sthncfctc ca nhsd hffh `rhvct odffh sgklpdask ghrochgk.

8) Ocurdtcgc

C ocurdtcgc gkstctucsgkak ua prdscock ekaohldathfd adf trhtthldatk odffksgklpdask ghrochgk. Wkak sthtc clpcd`htc 7 gfhssc oc ocurdtcgc9

8. ocurdtcgc odffhash9 eurksdlcod, hgcok dthgrcacgk gbd h`csgkak calhacdrh lkftk rhpcoh sd skllcacstrhtc pdr vch daokvdaksh. ]ksskakprkvkghrd cpkjhfcdlch:

>. ocurdtcgc tchzcocgc9 gfkrktchzcod do corkgfkrktchzcod h`csgkak suf tunufkprkssclhfd d ocsthfd. Wkak ocurdtcgc lkodrhtc:

7. hath`kacstc odffhfokstdrkad9 spcrkakfhttkad. Aka ghush cpkjhfcdlchd fh suh hsskgchzckad gka c ocurdtcgc odffhash d tchzcocgc hcuth adfprdvdacrfh.

Tah gklpfcghazh odffh tdrhpch ocurdtcgh catdascvh fhfghfksc cpkgfk-rdlcgh.

Ocurdtcgc odffhash

Eurksdlcod (FHWCR)

Hgcok dthgrcacgk (DODG^CA)

_chzcocgc

Gfkrktchzcod (OCT^CF)

Corkgfkrktchzcod(DWCO^DR)

Hatchfokstdrkacgc

Wpcrkakfhttkad (HFOHG_KAD)

]kthssck ghardkahtk (JHA^DAKF)

Wkllcacstrhzckad pdr ks

>-7 l`/j`/ ocd ca > oksc (lhx 5

l`/j`)>-7 l`/j`/ocd ca > oksc

>=-?= l`/j`/ocd ca >-7 oks

>-4 l`/j`/ocd ca >-7 oksc

>-7 l`/j`/ocd ca > oksc

8-7 l`/j`/ocd ca > oksc

Wkllcacstrhzckad DU

8-> l`/j`/ oksd

8 l`/j`/ oksd

8-7 l`/j`/ocd ca > oksc

>) Uhskocfhthtkrc

C vhskocfhthtkrc rcougkak fd rdscstdazd pdrcedrcgbd d qucaoc cf pkst-ghrcgk,ehgcfcthak fk svukthldatk vdatrcgkfhrd d oc gkasd`udazh huldathak fh`ctthth scstkfcgh sdazh lkocghrd fk sthtk gkatrhttcfd d sdazh huldathrdcf gkasulk oc kssc`dak. Wkak gkluadldatd ocvcsc ca nhsd hffhzckad

prdvhfdatd ca hrtdrcksc, vdaksc d lcstc.Ca dt pdochtrcgh skak pc erdqudatdldatd ushtc c vhskocfhthtkrc lcstc9


7/10

HGD cacnctkrc9 ushtc gkld ehrlhgc oc 8hsgdfth h`csgkak httrhvdrsk fc-acnczckad odffdazclh gbd ghthfczzh fh gkavdrsckad odffha`cktdascah Ccahttcvh ca ha`cktdascah CC, pktdatd vhskgkstrcttkrd. cougkak fh lkrthfct

odf >4%, rcougkak fh scatklhtkfk`ch d c pdrckoc oc kspdohfczzhzckad,lc`fckrhak fh tkffdrhazh hffk sekrzk. Wkak gkatrkcaocghtc ca ghsk oc cpk-tdasckad scatklhtcgh, cpdrjhfcdlch, stdaksc odffhrtdrch rdahfd ncfhtdrhfd,euazckahfct rdahfd ca pd``ckrhldatk. ndad gklcagchrd gka fh oksd lcaclh d cagrdldathrfh ak ho hvdrduah rcspksth gfcacgh.

EH^LHGC

Ghptkprcf (GH]K_DA)

Dahfhprcf (DAH]^DA)

Oksd CACYCHFD

Adkahtc9=.=4-=.8 l`/j` oksd kàc 2 krdFhtthatc d nhlncac9=.84-=.7l`/j` oksd kàc 2 krdHokfdsgdatc95.>4- 8>.4 l`/ oksd kàc 2-8> krd

=.8-=.4 l`/j`/ocd kàc 8>->? krd

Oksd LHWWCLH

=.4 l`/j`/oksd kàc 2 krd

> l`/j`/oksd kàc 2 krd

4= l`/ oksd kàc 2-8> krd

?= l`/ocd kàc 8>->? krd

7) Caktrkpc

Uc skak 7 gfhssc oc ehrlhgc caktrkpc9

8. `fcgkscoc oc`cthfcgc:>. n8 h`kacstc:

7. cacnctkrc odffh eksekocdstdrhsc.

Oc`cthfd

Fh oc`ksscah fh prdphrhzckad ushth ca pdochtrch. Kftrd hffdeedttk caktrkpkhttrhvdrsk fcacnczckad odffh pklph Ah-J-H_]hsc oc ldlnrhah, fh oc`cthfd

ua ehrlhgk sclphtcgkcacnctkrd.Akaksthatd fh oc`ksscah sch hlpchldatd ushth pdr fk sgklpdaskghrochgk, pkgbc skak `fc stuoc ca dt pdochtrcgh gbd ad suppkrthak kldak fusk.Httuhfldatd fd caocghzckac hf trhtthldatk gka oc`cthfd skak9 pdrscstdazh odc scatklc ca phzcdatc `c trhtthtc gka ocurdtcgk, HGD

cacnctkrd d nnfkgghatd: hrctlcd cpdrgcadtcgbd skprhvdatrcgkfhrd gbd ghushak k gklpfcghak fk

sgklpdask ca adkahtc k fhtthatc.


8/10

_hndffh odc oksh``c pdr ks

FHAKRCA

]rdlhturk (6 70 sdtt. D@)

Adkahtk h tdrlcad

Nhlncac (6 > haac)

Nhlncac (1 > haac)

Oksd tkthfd oc oc`cthfczzhzckad

(/j`/ocd)

>=->4

7=

7=-?=

7=-?=

Lhatdacldatk

(/j`/ocd)

4

2-8=

2-8=

2-8=

Wc caczch fh oc`cthfczzhzckad oc ua phzcdatd skllcacstrhaok sunctk fh ldt

odffh oksd oc htthggk, qucaoc okpk 2 krd d cf rclhadatd okpk hftrd2 krd. Cf lhatdacldatk caczch 8> krd okpk fh skllcacstrhzckad odffuf-tclh odffd oksc oc htthggk do kppkrtuak rcpdtdrd ua DG@ d rcgdrghrddvdatuhfc sdàc oc tksscgct. Fh oksd odf lhatdacldatk vh suoocvcsh ca> skllcacstrhzckad.Wd sc ush fh vch daokvdaksh c oksh``c oh ushrd skak cf 04% oc qudffc pdr ks.Fh oc`ksscah gkatrkcaocghth ca prdsdazh oc NHU, thlpkahldatk ghrochgk

d ghrocklckphtch cpdrtrkgh.Cf rha`d tdrhpdutcgk =.4->.= a`/lf. Ocvdrsc ehrlhgc catdrh`csgkak gka fhoc`cthfd huldathaokad fh gkagdatrhzckad scdrcgh, ca phrtcgkfhrd hlckohrk-ad, vdrhphlcfd do drctrklcgcah. ]rclh d ourhatd cf trhtthldatk oc`cthfcgk adgdsshrck dsdùcrd ua DG@ do uah jhfcdlch, pdrgb fcpkjhfcdlchprdocspkad hffh tksscgct oc`cthfcgh.C sdàc oc tksscgct oc`cthfcgh gkascstkak adffk svcfuppk oc hrctlcd oh hulda-

thth hutklhtcgct k adffh odprdssckad odffh gkaouzckad htrckvdatrcgkfhrd.

n8 H`kacstc

Fhzckad caktrkph oc ehrlhgc gkld fh okphlcah d fh oknuthlcah skl-lcacstrhtc pdr caeusckad gkatcauh, serutthth adffcasuegcdazh ghrochgh

rderhtthrch hffh tdrhpch gkavdazckahfd d adffh scaorkld oh nhssh `ctththsdgkaohrch ho catdrvdatc ghrockgbcrur`cgc.Fh okphlcah kftrd ho hvdrd ua deedttk ocrdttk suc rdgdttkrc n8 h`kacstc,prklukvd cf rcfhsgck oc akrhordahfcah ohffd tdrlcahzckac adrvksd scl-phtcgbd. C sukc deedttc skak gkrrdfhtc hffd oksc. Gka nhssk oksh``ck (6 4`)stclkfh c rdgdttkrc okphlcadr`cgc prkougdaok vhskocfhthzckad rdahfd, hoksc trh 4-8=`bh deedttk caktrkpk d prkvkgh ua huldatk odffh `ctthth, hoksc supdrckrd g httcvct h-hordadr`cgh gbd odtdrlcah vhskgkstrczckadpdrcedrcgh.


9/10

Fh oknuthlcah bh uahzckad prclctcvhldatd caktrkph, gka uah fcdvdvhskocfhthzckad pdrcedrcgh.Fd oksc d fd lkohfct oc prdphrhzckad skak rcpkrthtd ca thndffh.

EH^LHGK OKWH@@CK

Okphlcah (^DUCUHA) >- 4 /j`/lca (rdahfd)4-84 /j`/lca (caktrkpk)1 84 /j`/lca (prdsskrck)

Oknuthlcah (OKNT_^DR) >->= /j`/lca

Cacnctkrc odffh eksekocdstdrhsc

Wkak ehrlhgc gbd prdsdathak uah pktdatd hzckad caktrkph d vhskocfhthatd.Fd caocghzckac h fkrk usk skak sclcfc h qudffd odc ndth 8 h`kacstc.

EH^LHGK OKWH@@CK

Hlrcakad (CAKGK^) 4-8= /j`/ lca

Dakxclkad (]D^EHA) 4->= /j`/lca

?) nNfkgghatc

C nNfkgghatc skak ldak gkluadldatd utcfczzhtc adf trhtthldatk sthaohroodffk sgklpdask ghrochgk grkacgk ca dt pdochtrcgh, sdnndad gc schak ekrtcdvcodazd odffh fkrk utcfct ca dt houfth.Dssc h`crdnndrk httdauhaok fhttcvhzckad adurk-hordadr`cgh rdspkash-ncfd odffh ocseuazckad lckghrocgh, odffhpkptksc d odf rclkodffhldatkvdatrcgkfhrd.Cf ghrvdocfkfkfk (Ocfhtrdao) cf ehrlhgk httuhfldatd pc utcfczzhtk,sdgkaok c ohtc ocspkacncfc ca fdttdrhturh, ca qudsth ghtd`krch oc phzcda-tc. Okvrdnnd dssdrd catrkokttk ca phzcdatc gka sgklpdask ghrochgk

grkacgk sthncfd ho ua oksh``ck caczchfd oc =.=? l`/j` pdr ks > vkftdhf o oh huldathrd fdathldatd ak ho uah oksd oc =.7> l`/j` pdr ks> vkftd hf o. clpkrthatd gkluaqud prdgcshrd gbd httuhfldatd aka gc skak ohtc gbdoclkstrcak fdeghgch, ca tdrlcac oc lc`fckrhldatk odffh skprhvvcvdazh,oc qudsth ghtd`krch oc ehrlhgc ca phzcdatc pdochtrcgc.


10/10

Ncnfck`rheh dssdazchfd

- Jhatkr ]E dt hf. ]rdsdathtcka, och`akscs, hao ldocghf lhah`dldat ke bdhrtehcfurd ca gbcforda9 Ghahocha Ghrockvhsgufhr Wkgcdty `ucodfcads. GbcfordasBdhrt Ehcfurd Wtuoy @rkup. Gha I Ghrockf. >=87:>39 8474-4>.

- Edatka L, Nurgb L. Taodrsthaoca` gbrkacg bdhrt ehcfurd. Hrgb Ocs gbcfo.>==0: 3>928>-85.

- Lkeedtt NW, Gbha` HG. Euturd ]bhrlhgkfk`cg h`dats ekr trdhtldat ke bdhrtehcfurd. ]dochtr Ghrockf. >==5: >09477-448.

27_scompenso cardiaco optimized

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