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Insuffisance cardiaque - Historique des versions
2026-09-02T03:42:32Z
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https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5345&oldid=prev
Julien : /* Traitement */
2025-05-13T08:18:41Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:18</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l49" >Ligne 49 :</td>
<td colspan="2" class="diff-lineno">Ligne 49 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Pas encore validé par Swissmedic</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Pas encore validé par Swissmedic</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Traitement des comorbidités</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Traitement des comorbidités</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <u>Si phénotype obèse:</u> '''sémaglutide <del class="diffchange diffchange-inline">?</del>''' y compris en l'absence de diabète</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* <u>Si phénotype obèse:</u> '''sémaglutide''' y compris en l'absence de diabète</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétiques''': contrôle de la surcharge volémique</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétiques''': contrôle de la surcharge volémique</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5344&oldid=prev
Julien : /* Traitement */
2025-05-13T08:17:56Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:17</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l43" >Ligne 43 :</td>
<td colspan="2" class="diff-lineno">Ligne 43 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Traitement ===</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Traitement ===</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">* '''Diurétiques''': contrôle </del>de la <del class="diffchange diffchange-inline">surcharge volémique</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">4 piliers par analogie avec le traitement </ins>de la <ins class="diffchange diffchange-inline">HFrEF:</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''': empagliflozine (Forxiga) selon EMPEROR-Preserved 2021<ref>https://www.nejm.org/doi/full/10.1056/NEJMoa2107038</ref> et dapagliflozine (DELIVER 2022)</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''': empagliflozine (Forxiga) selon EMPEROR-Preserved 2021<ref>https://www.nejm.org/doi/full/10.1056/NEJMoa2107038</ref> et dapagliflozine (DELIVER 2022)</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* '''Finérénone <del class="diffchange diffchange-inline">?</del>''': Antagoniste des récepteurs minéralocorticoïdes</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* '''Finérénone''': Antagoniste des récepteurs minéralocorticoïdes</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** FINEARTS-HF 2024</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** FINEARTS-HF 2024</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Pas encore validé par Swissmedic</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Traitement des comorbidités</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* <u>Si phénotype obèse:</u> '''sémaglutide ?''' y compris en l'absence de diabète</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* <u>Si phénotype obèse:</u> '''sémaglutide ?''' y compris en l'absence de diabète</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">Traitement des comorbidités</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* <ins class="diffchange diffchange-inline">'''Diurétiques''': contrôle de la surcharge volémique</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection réduite (HFrEF) ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection réduite (HFrEF) ==</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5343&oldid=prev
Julien : /* Traitement */
2025-05-13T08:15:49Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
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<col class="diff-marker" />
<col class="diff-content" />
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:15</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l47" >Ligne 47 :</td>
<td colspan="2" class="diff-lineno">Ligne 47 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Finérénone ?''': Antagoniste des récepteurs minéralocorticoïdes</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Finérénone ?''': Antagoniste des récepteurs minéralocorticoïdes</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** FINEARTS-HF 2024</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** FINEARTS-HF 2024</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* <u>Si phénotype obèse:</u> '''sémaglutide ?''' y compris en l'absence de diabète</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Traitement des comorbidités</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Traitement des comorbidités</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5342&oldid=prev
Julien : /* Traitement */
2025-05-13T08:14:17Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
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<col class="diff-content" />
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:14</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l44" >Ligne 44 :</td>
<td colspan="2" class="diff-lineno">Ligne 44 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Traitement ===</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Traitement ===</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétiques''': contrôle de la surcharge volémique</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétiques''': contrôle de la surcharge volémique</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">* '''Anti-hypertenseurs''': cible tensionnelle < 130 mmHg</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''': empagliflozine (Forxiga) selon EMPEROR-Preserved 2021<ref>https://www.nejm.org/doi/full/10.1056/NEJMoa2107038</ref> <ins class="diffchange diffchange-inline">et dapagliflozine (DELIVER 2022)</ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''': empagliflozine (Forxiga) selon EMPEROR-Preserved 2021<ref>https://www.nejm.org/doi/full/10.1056/NEJMoa2107038</ref></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">* '''Finérénone ?''': Antagoniste des récepteurs minéralocorticoïdes</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">** FINEARTS-HF 2024</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">* Traitement des comorbidités</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection réduite (HFrEF) ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection réduite (HFrEF) ==</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5341&oldid=prev
Julien : /* Suivi */
2025-05-13T08:08:30Z
<p><span dir="auto"><span class="autocomment">Suivi</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:08</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l101" >Ligne 101 :</td>
<td colspan="2" class="diff-lineno">Ligne 101 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Maximum 2 unités d'alcool par jour</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Maximum 2 unités d'alcool par jour</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* 30 minutes d'activité physique 5 jours par semaine</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* 30 minutes d'activité physique 5 jours par semaine</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>== Suivi ==</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>== Suivi <ins class="diffchange diffchange-inline">et cibles </ins>==</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Cible tensionnelle: <130/80 mmHg</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Cible tensionnelle: <130/80 mmHg</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* In patients hospitalized with acute heart failure, scheduling an early follow-up appointment (within 7 days) to review the medication list, assess the patient's volume status and adherence to diet and medications, and reinforce patient education points reduces the risk for heart failure readmission.<ref>https://mksap18.acponline.org/app/topics/cv/mk18_a_cv_s4/mk18_a_cv_s4_8_3</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* In patients hospitalized with acute heart failure, scheduling an early follow-up appointment (within 7 days) to review the medication list, assess the patient's volume status and adherence to diet and medications, and reinforce patient education points reduces the risk for heart failure readmission.<ref>https://mksap18.acponline.org/app/topics/cv/mk18_a_cv_s4/mk18_a_cv_s4_8_3</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Echocardiographie de contrôle '''dès titration médicamenteuse maximale'''</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Echocardiographie de contrôle '''dès titration médicamenteuse maximale'''</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">Dosage de la </del>'''<del class="diffchange diffchange-inline">ferritine</del>''' aux 6 mois</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* '''<ins class="diffchange diffchange-inline">Ferritine</ins>'''</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** <del class="diffchange diffchange-inline">cible: </del>>100 mg/l ou <del class="diffchange diffchange-inline">si </del>100-<del class="diffchange diffchange-inline">300 </del>mg/l ET <del class="diffchange diffchange-inline">sat Tf </del><20%</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">** Dosage de la ferritine </ins>aux 6 mois</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** <ins class="diffchange diffchange-inline">Cible ferritine </ins>>100 mg/l ou 100-<ins class="diffchange diffchange-inline">299 </ins>mg/l ET <ins class="diffchange diffchange-inline">coefficient de saturation de la transferrine </ins><20%</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">** Substitution par carboxymaltose IV (forme PO n'a jamais été validée car mauvaise absorption)</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">** diminue risque cardiovasculaire de 21% mais étude non significative (AFFIRM-HF)</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Références ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Références ==</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Category:Cardiologie]]</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Category:Cardiologie]]</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5340&oldid=prev
Julien : /* Traitement */
2025-05-13T08:04:36Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
<col class="diff-content" />
<col class="diff-marker" />
<col class="diff-content" />
<tr class="diff-title" lang="fr">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 08:04</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l76" >Ligne 76 :</td>
<td colspan="2" class="diff-lineno">Ligne 76 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Ivabradine''' [https://compendium.ch/product/1064518-procoralan-cpr-pell-5-mg (Procoralan®)] should be considered for patients with symptomatic heart failure and an ejection fraction less than or equal to 35% who have an elevated heart rate (≥70/min) in sinus rhythm despite maximally tolerated doses of β-blocker therapy. It is important to note that ivabradine should be given in addition to β-blocker therapy, not in its place.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Ivabradine''' [https://compendium.ch/product/1064518-procoralan-cpr-pell-5-mg (Procoralan®)] should be considered for patients with symptomatic heart failure and an ejection fraction less than or equal to 35% who have an elevated heart rate (≥70/min) in sinus rhythm despite maximally tolerated doses of β-blocker therapy. It is important to note that ivabradine should be given in addition to β-blocker therapy, not in its place.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''' [[Diabète_mellitus#Traitement_pharmacologique|empagliflozine]] indépendamment de la présence d'un diabète de type II</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''' [[Diabète_mellitus#Traitement_pharmacologique|empagliflozine]] indépendamment de la présence d'un diabète de type II</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Contre-indications: eGFR <20 ml/min/1,73m2 (empagliflozine) et eGFR <25 ml/min/1,73m2 (dapagliflozine), TAS <95 mmHg, grossesse/allaitement, diabète type 1.</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Approche horizontale. Introduire et titrer les traitements le plus rapidement possible. Adapter l'introduction des traitements au profil du patient, par exemple:</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Approche horizontale. Introduire et titrer les traitements le plus rapidement possible. Adapter l'introduction des traitements au profil du patient, par exemple:</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Profil hypertendu: IEC/Sartan/ARNI en premier lieu</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Profil hypertendu: IEC/Sartan/ARNI en premier lieu</div></td></tr>
<tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l81" >Ligne 81 :</td>
<td colspan="2" class="diff-lineno">Ligne 82 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Hypotendu: i-SGLT2 en premier lieu</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Hypotendu: i-SGLT2 en premier lieu</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Hyperkaliémie-maladie rénale:</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Hyperkaliémie-maladie rénale:</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">== Insuffisance cardiaque à fraction d'éjection améliorée (HFimpEF) ==</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* FEVG initiale <40% qui passe à >40% avec un delta d'au moins 10%</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Pronostic similaire à la population HFpEF</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Arrêt des traitements pronostiques ? TRED-HF (2019) montre très haut risque de rechute à l'arrêt des traitements</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection modérément réduite (HFmrEF) ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection modérément réduite (HFmrEF) ==</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5339&oldid=prev
Julien : /* Traitement */
2025-05-13T07:59:26Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
<col class="diff-content" />
<col class="diff-marker" />
<col class="diff-content" />
<tr class="diff-title" lang="fr">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 07:59</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l63" >Ligne 63 :</td>
<td colspan="2" class="diff-lineno">Ligne 63 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** A titrer à dose maximale ou jusqu'à l'apparition d'une hypotension symptomatique.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** A titrer à dose maximale ou jusqu'à l'apparition d'une hypotension symptomatique.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>Alternative:</u> '''ARA'''</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>Alternative:</u> '''ARA'''</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Angiotensin receptor–neprilysin inhibitor (ARNI)''' = sacubitril-valsartan [https://compendium.ch/product/1305394-entresto-cpr-pell-50-mg (Entresto®)] → chez les patients avec insuffisance cardiaque symptomatique '''et''' une FEVG abaissée à '''≤40%'''. '''CAVE''' si switch depuis un IEC: attendre 72h le wash-out de l'IEC avant l'introduction de sacubitril-valsartan<del class="diffchange diffchange-inline">.</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Angiotensin receptor–neprilysin inhibitor (ARNI)''' = sacubitril-valsartan [https://compendium.ch/product/1305394-entresto-cpr-pell-50-mg (Entresto®)] → chez les patients avec insuffisance cardiaque symptomatique '''et''' une FEVG abaissée à '''≤40%'''.</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*** </ins>'''CAVE''' si switch depuis un IEC: attendre <ins class="diffchange diffchange-inline">36-</ins>72h le wash-out de l'IEC avant l'introduction de sacubitril-valsartan <ins class="diffchange diffchange-inline">(risque d'angioedème)</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''β-bloquant''': évite le remodelage, augmente la fraction d'éjection, diminue la mortalité et les hospitalisations en association avec un IEC/ARA.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''β-bloquant''': évite le remodelage, augmente la fraction d'éjection, diminue la mortalité et les hospitalisations en association avec un IEC/ARA.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Non lié à la classe mais à la substance elle-même. Privilégier '''bisoprolol''', '''carvédilol''', et '''métoprolol succinate'''</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Non lié à la classe mais à la substance elle-même. Privilégier '''bisoprolol''', '''carvédilol''', et '''métoprolol succinate'''</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5338&oldid=prev
Julien : /* Traitement */
2025-05-13T07:55:53Z
<p><span dir="auto"><span class="autocomment">Traitement</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
<col class="diff-content" />
<col class="diff-marker" />
<col class="diff-content" />
<tr class="diff-title" lang="fr">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 07:55</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l65" >Ligne 65 :</td>
<td colspan="2" class="diff-lineno">Ligne 65 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Angiotensin receptor–neprilysin inhibitor (ARNI)''' = sacubitril-valsartan [https://compendium.ch/product/1305394-entresto-cpr-pell-50-mg (Entresto®)] → chez les patients avec insuffisance cardiaque symptomatique '''et''' une FEVG abaissée à '''≤40%'''. '''CAVE''' si switch depuis un IEC: attendre 72h le wash-out de l'IEC avant l'introduction de sacubitril-valsartan.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Angiotensin receptor–neprilysin inhibitor (ARNI)''' = sacubitril-valsartan [https://compendium.ch/product/1305394-entresto-cpr-pell-50-mg (Entresto®)] → chez les patients avec insuffisance cardiaque symptomatique '''et''' une FEVG abaissée à '''≤40%'''. '''CAVE''' si switch depuis un IEC: attendre 72h le wash-out de l'IEC avant l'introduction de sacubitril-valsartan.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''β-bloquant''': évite le remodelage, augmente la fraction d'éjection, diminue la mortalité et les hospitalisations en association avec un IEC/ARA.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''β-bloquant''': évite le remodelage, augmente la fraction d'éjection, diminue la mortalité et les hospitalisations en association avec un IEC/ARA.</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** Non lié à la classe mais à la substance elle-même <del class="diffchange diffchange-inline">(privilégier </del>'''bisoprolol''', '''carvédilol''', et '''métoprolol succinate'''<del class="diffchange diffchange-inline">)</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** Non lié à la classe mais à la substance elle-même<ins class="diffchange diffchange-inline">. Privilégier </ins>'''bisoprolol''', '''carvédilol''', et '''métoprolol succinate'''</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** <del class="diffchange diffchange-inline">Introduire le β</del>-<del class="diffchange diffchange-inline">bloquant lorsque le patient est euvolémique ou presque euvolémique. </del>'''CAVE''' si asthme, BPCO, évidence de bronchospasme ou exacerbation de maladie pulmonaire.</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>**<ins class="diffchange diffchange-inline">* Cible FC 60</ins>-<ins class="diffchange diffchange-inline">70/min</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">** </ins>'''CAVE''' si asthme, BPCO, évidence de bronchospasme ou exacerbation de maladie pulmonaire.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Augmenter la dose toutes les 2-4 semaines pour obtenir une FC de 60/min ou dès l'apparition de symptômes d'hypotension.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Augmenter la dose toutes les 2-4 semaines pour obtenir une FC de 60/min ou dès l'apparition de symptômes d'hypotension.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétique de l'anse''': furosémide, torasémide au plus petit dosage possible pour obtenir l'euvolémie.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Diurétique de l'anse''': furosémide, torasémide au plus petit dosage possible pour obtenir l'euvolémie.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Digoxine''': si HFrEF et [[fibrillation auriculaire]] concomitante, mais n'améliore pas la survie.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Digoxine''': si HFrEF et [[fibrillation auriculaire]] concomitante, mais n'améliore pas la survie.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Antagonistes de l'aldostérone''': eplérénone, spironolactone si HFrEF après un STEMI et dans le cadre d'une insuffisance cardiaque symptomatique. Effet anti-fibrotique.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Antagonistes de l'aldostérone''': eplérénone, spironolactone si HFrEF après un STEMI et dans le cadre d'une insuffisance cardiaque symptomatique. Effet anti-fibrotique.</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*** 25 mg d'emblée</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Ivabradine''' [https://compendium.ch/product/1064518-procoralan-cpr-pell-5-mg (Procoralan®)] should be considered for patients with symptomatic heart failure and an ejection fraction less than or equal to 35% who have an elevated heart rate (≥70/min) in sinus rhythm despite maximally tolerated doses of β-blocker therapy. It is important to note that ivabradine should be given in addition to β-blocker therapy, not in its place.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** <u>A considérer:</u> '''Ivabradine''' [https://compendium.ch/product/1064518-procoralan-cpr-pell-5-mg (Procoralan®)] should be considered for patients with symptomatic heart failure and an ejection fraction less than or equal to 35% who have an elevated heart rate (≥70/min) in sinus rhythm despite maximally tolerated doses of β-blocker therapy. It is important to note that ivabradine should be given in addition to β-blocker therapy, not in its place.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''' [[Diabète_mellitus#Traitement_pharmacologique|empagliflozine]] indépendamment de la présence d'un diabète de type II</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''Inhibiteur du SGLT-2''' [[Diabète_mellitus#Traitement_pharmacologique|empagliflozine]] indépendamment de la présence d'un diabète de type II</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Approche horizontale. Introduire et titrer les traitements le plus rapidement possible. Adapter l'introduction des traitements au profil du patient, par exemple:</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Profil hypertendu: IEC/Sartan/ARNI en premier lieu</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Profil tachycarde, FA: B-bloquant en premier lieu</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Hypotendu: i-SGLT2 en premier lieu</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Hyperkaliémie-maladie rénale:</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection modérément réduite (HFmrEF) ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection modérément réduite (HFmrEF) ==</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5337&oldid=prev
Julien : /* Insuffisance cardiaque à fraction d'éjection conservée (HFpEF) */
2025-05-13T07:45:07Z
<p><span dir="auto"><span class="autocomment">Insuffisance cardiaque à fraction d'éjection conservée (HFpEF)</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
<col class="diff-content" />
<col class="diff-marker" />
<col class="diff-content" />
<tr class="diff-title" lang="fr">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 07:45</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l23" >Ligne 23 :</td>
<td colspan="2" class="diff-lineno">Ligne 23 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection conservée (HFpEF) ==</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Insuffisance cardiaque à fraction d'éjection conservée (HFpEF) ==</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><u>Synonyme:</u> insuffisance cardiaque '''diastolique''' ou ''heart failure with preserved ejection fraction (HFpEF)''</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><u>Synonyme:</u> insuffisance cardiaque '''diastolique''' ou ''heart failure with preserved ejection fraction (HFpEF)''</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* HFpEF-like: CMH, amyloïdose, maladie de surcharge, sténose aortique sévère</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Diagnostic ===</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=== Diagnostic ===</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* <u>Approche simplifiée</u>: la probabilité augmente avec le nombre de critères suivants remplis:</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* <u>Approche simplifiée</u>: la probabilité augmente avec le nombre de critères suivants remplis:</div></td></tr>
</table>
Julien
https://médecine.top/index.php?title=Insuffisance_cardiaque&diff=5336&oldid=prev
Julien : /* Etiologie */
2025-05-13T07:42:59Z
<p><span dir="auto"><span class="autocomment">Etiologie</span></span></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
<col class="diff-marker" />
<col class="diff-content" />
<col class="diff-marker" />
<col class="diff-content" />
<tr class="diff-title" lang="fr">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Version précédente</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Version du 13 mai 2025 à 07:42</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l52" >Ligne 52 :</td>
<td colspan="2" class="diff-lineno">Ligne 52 :</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* [[Maladie coronarienne]]</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* [[Maladie coronarienne]]</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* [[Myocardite]]</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* [[Myocardite]]</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Toxique (OH, anthracyclines, ...)</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Cardiopathie valvulaire</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Cardiopathie valvulaire</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Maladie infiltrative</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Maladie infiltrative</div></td></tr>
</table>
Julien