{"id":25041,"date":"2023-04-19T21:41:47","date_gmt":"2023-04-19T14:41:47","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25041"},"modified":"2023-04-20T17:22:07","modified_gmt":"2023-04-20T10:22:07","slug":"suy-tim-phan-suat-tong-mau-giam-thuoc-nen-tang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/suy-tim-phan-suat-tong-mau-giam-thuoc-nen-tang\/","title":{"rendered":"Thu\u1ed1c n\u1ec1n t\u1ea3ng b\u1ec7nh suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m"},"content":{"rendered":"

Thu\u1ed1c n\u1ec1n t\u1ea3ng suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m l\u00e0 b\u1ed1n \u201ctr\u1ee5 c\u1ed9t\u201d ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa n\u00ean c\u00e2n nh\u1eafc k\u1ebft h\u1ee3p s\u1edbm mang l\u1ea1i l\u1ee3i \u00edch t\u1ed1i \u0111a cho ng\u01b0\u1eddi b\u1ec7nh nh\u01b0ng lu\u00f4n ph\u1ea3i l\u01b0u \u00fd kh\u00eda c\u1ea1nh c\u00e1 c\u00f3 th\u1ec3 h\u00f3a v\u00e0 \u0111\u1ea3m b\u1ea3o an to\u00e0n. M\u1ed9t ng\u01b0\u1eddi b\u1ec7nh, trong t\u1eebng giai \u0111o\u1ea1n di\u1ec5n bi\u1ebfn bi\u1ebfn c\u1ee7a suy tim, c\u00f3 th\u1ec3 dung n\u1ea1p t\u1ed1t v\u1edbi k\u1ebft h\u1ee3p \u0111\u1ee7 c\u1ea3 4 lo\u1ea1i thu\u1ed1c nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 ch\u1ec9 l\u00e0 3, 2 ho\u1eb7c 1 trong 4 lo\u1ea1i thu\u1ed1c<\/strong> .<\/p>\n

\"Suy
Suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m thu\u1ed1c n\u1ec1n t\u1ea3ng<\/figcaption><\/figure>\n

1. Gi\u1edbi thi\u1ec7u<\/span><\/span><\/h2>\n

C\u00e1c nh\u00f3m thu\u1ed1c n\u1ec1n (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u00e1c nh\u00f3m thu\u1ed1c \u201ctr\u1ee5 c\u1ed9t\u201d), bao g\u1ed3m: (1) Nh\u00f3m \u1ee9c ch\u1ebf h\u1ec7 renin-angiotensin bao g\u1ed3m \u1ee9c ch\u1ebf men chuy\u1ec3n (ACE-I) ho\u1eb7c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin (ARB) ) ho\u1eb7c ch\u1ebf \u0111\u1ed9 k\u00e9p neprilysin v\u00e0 angiotensin (ARNI); <\/span>(2) Ch\u1eb9n beta giao c\u1ea3m; <\/span>(3) Thu\u1ed1c \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 mineralocorticoid ho\u1eb7c kh\u00e1ng aldosterone (MRA); <\/span>v\u00e0 (4) \u1ee8ng ch\u1ebf k\u00eanh \u0111\u1ed3ng v\u1eadn chuy\u1ec3n Natri-glucose 2 t\u1ea1i \u1ed1ng th\u1eadn (\u1ee9c ch\u1ebf SGLT2) gi\u00fap gi\u1ea3m t\u1eed vong, gi\u1ea3m nh\u1eadp vi\u1ec7n do suy tim, c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng suy tim \u1edf ng\u01b0\u1eddi b\u1ec7nh suy tim c\u00f3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m<\/a>.<\/span><\/span><\/p>\n

ARNI \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn cho b\u1ec7nh nh\u00e2n NYHA II-III, ACE-I ho\u1eb7c ARB \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n NYHA t\u1eeb II-IV, ACE-I \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng ARNI, ARB n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng t\u1ea3i \u0111\u01b0\u1ee3c v\u1edbi ACE-I ho\u1eb7c kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng ARNI.<\/span><\/span><\/p>\n

Nh\u00f3m ch\u1ebf \u0111\u1ed9 \u0111\u1ed3ng v\u1eadn chuy\u1ec3n Natri-glucose trong \u1ed1ng th\u1eadn (\u1ee9c ch\u1ebf SGLT2). <\/span>Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m t\u00e1i h\u1ea5p thu\/t\u0103ng th\u1ea3i glucose v\u00e0 natri. <\/span>Hai lo\u1ea1i thu\u1ed1c trong nh\u00f3m n\u00e0y l\u00e0 dapagliflozin ho\u1eb7c empagliflozin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ch\u1ec9 \u0111\u1ecbnh b\u1ea5t k\u1ec3 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 k\u00e8m theo li\u1ec7t k\u00ea hay kh\u00f4ng.<\/span><\/span><\/p>\n

Ngo\u1ea1i tr\u1eeb nh\u00f3m \u1ee9c ch\u1ebf SGLT2 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi ch\u1ee9c n\u0103ng \u0111i\u1ec1u ch\u1ec9nh c\u1ed1 \u0111\u1ecbnh, b\u00e1c s\u0129 th\u1ef1c h\u00e0nh lu\u00f4n c\u1ea7n l\u01b0u \u00fd \u0111i\u1ec1u ch\u1ec9nh c\u00e1c nh\u00f3m thu\u1ed1c ARNI ho\u1eb7c ACE-I ho\u1eb7c ARB, ch\u1eb9n beta giao c\u1ea3m v\u00e0 MRA t\u1eeb kh\u1edfi \u0111\u1ed9ng th\u1ea5p nh\u1ea5t \u0111\u1ebfn m\u1ee9c t\u1ed1i thi\u1ec3u max m\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ea3i \u0111\u01b0\u1ee3c.<\/span><\/span><\/p>\n

Nh\u1eefng lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c qu\u1ea3ng c\u00e1o trong \u0111i\u1ec1u tr\u1ecb suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m.<\/span><\/span><\/strong><\/p>\n

2. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ACE-I)<\/span><\/span><\/h2>\n
    \n
  • \u1ee8c ch\u1ebf men (enzym) x\u00fac t\u00e1c chuy\u1ec3n Angiotensin I th\u00e0nh Angiotensin II l\u00e0m gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 Angiotensin II, \u0111\u1ed3ng th\u1eddi l\u00e0m t\u0103ng nhi\u1ec7t \u0111\u1ed9 Bradykinin, m\u1ed9t ch\u1ea5t t\u00e1c d\u1ee5ng g\u1ea7n nh\u01b0 ng\u01b0\u1ee3c chi\u1ec1u v\u1edbi Angiotensin II. <\/span>K\u1ebft qu\u1ea3 thu\u1ed1c s\u1ebd t\u00e1c \u0111\u1ed9ng \u0111i\u1ec1u ch\u1ec9nh h\u1ec7 th\u1ed1ng Renin – Angiotensin – Aldosterone (RAA) g\u00e2y gi\u00e3n m\u1ea1ch (t\u1ea5t c\u1ea3 c\u00e1c ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch), d\u1eabn \u0111\u1ebfn gi\u1ea3m c\u1ea3 ti\u1ec1n t\u1ea3i v\u00e0 h\u1eadu t\u1ea3i, gi\u1ea3m g\u00e1nh n\u1eb7ng cho tim.<\/span><\/span><\/li>\n
  • Thu\u1ed1c gi\u00fap c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng v\u00e0 gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n suy tim m\u1ea1n t\u00ednh.<\/span><\/span><\/li>\n
  • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn tr\u1ecdng: Huy\u1ebft \u00e1p th\u1ea5p, c\u01a1 \u0111\u1ed9ng m\u1ea1ch th\u1eadn hai b\u00ean, ph\u1ee5 n\u1eef c\u00f3 thai.<\/span><\/span><\/li>\n<\/ul>\n

    3. Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m<\/span><\/span><\/h2>\n
      \n
    • Ch\u1ebf \u0111\u1ed9 k\u00edch th\u00edch th\u00e1i qu\u00e1 c\u1ee7a h\u1ec7 th\u1ea7n kinh giao c\u1ea3m, m\u1ed9t c\u01a1 ch\u1ebf \u0111i\u1ec1u h\u00f2a ng\u01b0\u1ee3c trong suy tim m\u1ea1n t\u00ednh.<\/span><\/span><\/li>\n
    • Gi\u00fap c\u1ea3i thi\u1ec7n s\u1ef1 s\u1ed1ng c\u00f2n, gi\u1ea3m t\u00e1i nh\u1eadp vi\u1ec7n l\u00e0m \u0111\u1ee3t c\u1ea5p v\u00e0 gi\u1ea3m xung \u0111\u1ed9t th\u1eddi gian.<\/span><\/span><\/li>\n
    • Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb suy tim: carvedilol, metoprolol, bisoprolol v\u00e0 nebivolol.<\/span><\/span><\/li>\n
    • L\u1ee3i \u00edch c\u1ee7a ch\u1eb9n beta giao c\u1ea3m xu\u1ea5t hi\u1ec7n ch\u1eadm v\u00e0 l\u00e2u.\u00a0<\/span><\/span><\/li>\n
    • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: suy tim \u0111ang \u1edf giai \u0111o\u1ea1n m\u1ea5t b\u00f9, nh\u1ecbp ch\u1eadm, hen ph\u1ebf qu\u1ea3n.<\/span><\/span><\/li>\n<\/ul>\n

      \u00a04. Thu\u1ed1c \u1ee9c ch\u1ebf h\u1ea5p thu Mineralocorticoid (MRA)<\/span><\/span><\/h2>\n
        \n
      • Hay c\u00f2n g\u1ecdi l\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u kh\u00e1ng aldosterone, kh\u00f4ng ch\u1ec9 c\u00f3 t\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u m\u00e0 c\u00f2n h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng th\u00e1i qu\u00e1 c\u1ee7a vi\u1ec7c t\u0103ng aldosterone trong suy tim n\u1eb7ng, do \u0111\u00f3 l\u00e0m gi\u1ea3m co m\u1ea1ch \u0111\u1ed3ng th\u1eddi v\u1edbi t\u00ecnh tr\u1ea1ng gi\u1eef n\u01b0\u1edbc, ph\u1eadp ph\u1ed3ng c\u01a1 tim, suy th\u1eadn, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u1ed9i \u0111\u1ecba.<\/span><\/span><\/li>\n
      • Thu\u1ed1c l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 nh\u1eadp vi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy tim n\u1eb7ng.<\/span><\/span><\/li>\n
      • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn: suy th\u1eadn n\u1eb7ng, t\u0103ng kali m\u00e1u.<\/span><\/span><\/li>\n<\/ul>\n

        5. Thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 neprilysin v\u00e0 angiotensin (ARNI)<\/span><\/span><\/h2>\n
          \n
        • Ph\u1ee9c h\u1ee3p Sacubitril\/Valsartan (Sacubitril l\u00e0 ti\u1ec1n ch\u1ea5t, sau \u0111\u00f3 chuy\u1ec3n h\u00f3a th\u00e0nh ch\u1ea5t ch\u1ebf ch\u1ebf enzyme Neprilysin, l\u00e0m t\u0103ng nhi\u1ec7t \u0111\u1ed9 c\u1ee7a peptid l\u1ee3i ti\u1ec3u) \u0111\u01b0\u1ee3c qu\u1ea3ng c\u00e1o l\u00e0 \u0111i\u1ec1u tr\u1ecb thay th\u1ebf cho nh\u00f3m \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c \u1ee9c ch\u1ebf h\u1ea5p th\u1ee5. angiotensin II.<\/span><\/span><\/li>\n
        • C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc nh\u1eafc Sacubitril\/Valsartan cho b\u1ec7nh nh\u00e2n suy tim m\u1ea1n t\u00ednh c\u0169ng nh\u01b0 suy tim c\u1ea5p \u0111\u00e3 \u1ed5n \u0111\u1ecbnh ngay m\u00e0 kh\u00f4ng b\u1eaft bu\u1ed9c ph\u1ea3i s\u1eed d\u1ee5ng \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 tr\u01b0\u1edbc.<\/span><\/span><\/li>\n
        • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn tr\u1ecdng: ti\u1ec1n s\u1eed d\u1ee5ng ph\u00f9 h\u1ee3p v\u1edbi thu\u1ed1c ACEI, suy th\u1eadn, c\u01a1 m\u1ea1ch th\u1eadn hai b\u00ean, ph\u1ee5 n\u1eef c\u00f3 thai.<\/span><\/span><\/li>\n
        • C\u1ea7n l\u01b0u \u00fd ng\u1eebng thu\u1ed1c ACEI \u00edt nh\u1ea5t 36 gi\u1edd (n\u1ebfu \u0111ang s\u1eed d\u1ee5ng) tr\u01b0\u1edbc khi kh\u1edfi \u0111\u1ed9ng \u0111i\u1ec1u tr\u1ecb thay th\u1ebf b\u1eb1ng ARNI.<\/span><\/span><\/li>\n<\/ul>\n

          6. Thu\u1ed1c \u1ee9c ch\u1ebf \u0111\u1ed3ng v\u1eadn Natri-glucose 2 (SGLT2i)<\/span><\/span><\/h2>\n
            \n
          • L\u00e0m t\u0103ng \u0111\u00e0o th\u1ea3i \u0111\u01b0\u1eddng v\u00e0 mu\u1ed1i qua n\u01b0\u1edbc ti\u1ec3u b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu glucose v\u00e0 natri trong \u1ed1ng th\u1eadn.<\/span><\/span><\/li>\n
          • Hi\u1ec7n nay 2 lo\u1ea1i thu\u1ed1c l\u00e0 dapagliflozin ho\u1eb7c empagliflozin \u0111\u01b0\u1ee3c qu\u1ea3ng c\u00e1o cho b\u1ec7nh nh\u00e2n suy tim ph\u00e2n ph\u00e2n tu\u1ea7n ho\u00e0n m\u00e1u gi\u1ea3m b\u1ea5t k\u1ec3 c\u00f3 b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng hay kh\u00f4ng. <\/span>C\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ee9ng minh gi\u1ea3m t\u1eed vong tim m\u1ea1ch v\u00e0 t\u00e1i nh\u1eadp vi\u1ec7n suy tim. <\/span>Thu\u1ed1c c\u00f2n \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1ec1 th\u1eadn c\u1ea5p v\u00e0 ng\u0103n ch\u1eb7n s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn v\u1ec1 l\u00e2u d\u00e0i.<\/span><\/span><\/li>\n
          • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn tr\u1ecdng: ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng. <\/span>T\u00ecnh tr\u1ea1ng gi\u1ea3m nh\u1eb9 \u0111\u1ed9 c\u00e2n l\u1ecdc c\u1ea7u th\u1eadn ngay sau khi kh\u1edfi \u0111\u1ed9ng c\u00f3 th\u1ec3 g\u1eb7p v\u00e0 th\u01b0\u1eddng ph\u1ee5c h\u1ed3i t\u1ed1t, nh\u00ecn chung kh\u00f4ng d\u1eabn \u0111\u1ebfn thu\u1ed1c ti\u1ebfp t\u1ee5c.<\/span><\/span><\/li>\n<\/ul>\n

            7. Thu\u1ed1c \u1ee9c ch\u1ebf AT1 c\u1ee7a angiotensin II (ARB):<\/span><\/span><\/h2>\n
              \n
            • \u1ee8c ch\u1ebf tr\u1ef1c ti\u1ebfp ti\u1ebfp nh\u1eadn ATI n\u01a1i angiotensine II g\u00e2y ra t\u00e1c d\u1ee5ng tr\u00ean c\u00e1c t\u1ed5 ch\u1ee9c \u0111\u00edch (m\u1ea1ch, th\u1eadn, tim.). <\/span>Kh\u00e1c v\u1edbi thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 AT1 c\u1ee7a angiotensine II kh\u00f4ng l\u00e0m t\u0103ng bradykinin n\u00ean \u00edt g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 ho khan, ph\u00f9 m\u1ea1ch (g\u1eb7p bi\u1ebfn ch\u1ee9ng kh\u00e1 ph\u1ed5 bi\u1ebfn khi s\u1eed d\u1ee5ng ACE-I).<\/span><\/span><\/li>\n
            • G\u1ea7n gi\u1ed1ng nh\u01b0 ACE-I, thu\u1ed1c ARB t\u00e1c d\u1ee5ng l\u00ean h\u1ec7 th\u1ed1ng RAA d\u1eabn \u0111\u1ebfn gi\u00e3n m\u1ea1ch, c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng t\u00e2m th\u1ea5t…<\/span><\/span><\/li>\n
            • \u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi b\u1ec7nh nh\u00e2n kh\u00f4ng dung n\u1ea1p v\u1edbi thu\u1ed1c ACE-I ho\u1eb7c kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb v\u1edbi ARNI.<\/span><\/span><\/li>\n
            • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn tr\u1ecdng: t\u01b0\u01a1ng t\u1ef1 nh\u01b0 thu\u1ed1c ACE-I.<\/span><\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

              Thu\u1ed1c n\u1ec1n t\u1ea3ng suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m l\u00e0 b\u1ed1n \u201ctr\u1ee5 c\u1ed9t\u201d ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa n\u00ean c\u00e2n nh\u1eafc k\u1ebft h\u1ee3p s\u1edbm mang l\u1ea1i l\u1ee3i \u00edch t\u1ed1i \u0111a cho ng\u01b0\u1eddi b\u1ec7nh nh\u01b0ng lu\u00f4n ph\u1ea3i l\u01b0u \u00fd kh\u00eda c\u1ea1nh c\u00e1 c\u00f3 th\u1ec3 h\u00f3a v\u00e0 \u0111\u1ea3m b\u1ea3o an to\u00e0n. M\u1ed9t ng\u01b0\u1eddi b\u1ec7nh, trong […]<\/p>\n","protected":false},"author":25,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nThu\u1ed1c n\u1ec1n t\u1ea3ng b\u1ec7nh suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m - Vinmec<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c n\u1ec1n t\u1ea3ng suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m l\u00e0 b\u1ed1n \u201ctr\u1ee5 c\u1ed9t\u201d ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa nh\u1eb1m mang l\u1ea1i l\u1ee3i \u00edch t\u1ed1i \u0111a cho ng\u01b0\u1eddi b\u1ec7nh\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Thu\u1ed1c n\u1ec1n t\u1ea3ng b\u1ec7nh suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m - 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