{"id":32264,"date":"2023-05-06T15:16:36","date_gmt":"2023-05-06T08:16:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32264"},"modified":"2023-05-16T00:47:56","modified_gmt":"2023-05-15T17:47:56","slug":"quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/","title":{"rendered":"Qu\u1ea3n l\u00fd R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng"},"content":{"rendered":"

R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim. C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu LV kh\u00f4ng tri\u1ec7u ch\u1ee9ng \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c ti\u00eau ch\u00ed kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng n\u00e0y. Hi\u1ec7n nay, ALVSD \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu LV v\u1edbi ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u LV b\u1ea5t th\u01b0\u1eddng, chuy\u1ec3n \u0111\u1ed9ng th\u00e0nh v\u00f9ng b\u1ea5t th\u01b0\u1eddng ho\u1eb7c c\u1ea3 hai.<\/strong><\/p>\n

C\u00e1c nghi\u00ean c\u1ee9u d\u1ef1a tr\u00ean d\u00e2n s\u1ed1 cho th\u1ea5y ALVSD c\u0169ng ph\u1ed5 bi\u1ebfn nh\u01b0 suy tim<\/a> (HF) v\u1edbi ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m (HFrEF). B\u1ec7nh tim c\u1ea5u tr\u00fac (bao g\u1ed3m r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu LV)\u00a0 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u c\u1ee7a HF \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 “HF giai \u0111o\u1ea1n B” trong h\u01b0\u1edbng d\u1eabn c\u1ee7a Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3. M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, nh\u01b0ng nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 nguy c\u01a1 cao m\u1eafc b\u1ec7nh suy tim l\u00e2m s\u00e0ng (t\u1ee9c l\u00e0 giai \u0111o\u1ea1n C ho\u1eb7c D) v\u00e0 t\u1eed vong, do \u0111\u00f3 \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 h\u1ecd ph\u1ea3i \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

C\u00e1ch ti\u1ebfp c\u1eadn \u0111\u1ec3 qu\u1ea3n l\u00fd r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb (ki\u1ec3m so\u00e1t c\u00e1c t\u00ecnh tr\u1ea1ng \u0111\u1ed3ng m\u1eafc, \u1ee9c ch\u1ebf hormone th\u1ea7n kinh v\u00e0 ki\u1ec3m so\u00e1t r\u1ed1i lo\u1ea1n nh\u1ecbp tim), tr\u00e1nh d\u00f9ng c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y suy tim (HF) v\u00e0 theo d\u00f5i ti\u1ebfn tri\u1ec3n.<\/p>\n

1. Qu\u1ea3n l\u00fd c\u00e1c t\u00ecnh tr\u1ea1ng \u0111\u1ed3ng m\u1eafc trong r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng\u00a0<\/strong><\/h2>\n

C\u00e1c \u0111i\u1ec1u ki\u1ec7n c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ho\u1eb7c g\u00f3p ph\u1ea7n g\u00e2y ra suy tim n\u00ean \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn v\u00e0 qu\u1ea3n l\u00fd theo c\u00e1c khuy\u1ebfn c\u00e1o ti\u00eau chu\u1ea9n. Nh\u1eefng t\u00ecnh tr\u1ea1ng n\u00e0y bao g\u1ed3m t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n lipid m\u00e1u, b\u00e9o ph\u00ec v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. B\u1ec7nh nh\u00e2n c\u0169ng n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 vi\u1ec7c cai thu\u1ed1c l\u00e1 c\u0169ng nh\u01b0 tr\u00e1nh s\u1eed d\u1ee5ng cocain, amphetamine v\u00e0 u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u.<\/p>\n

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3 nh\u01b0 c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 cho b\u1ec7nh c\u01a1 tim ho\u1eb7c b\u1ec7nh van n\u1eb7ng (h\u1eb9p ho\u1eb7c h\u1edf van tim).<\/p>\n

2. \u1ee8c ch\u1ebf th\u1ea7n kinh th\u1ec3 d\u1ecbch trong r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng <\/strong><\/h2>\n

Can thi\u1ec7p d\u01b0\u1ee3c l\u00fd trong qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 tr\u00ec ho\u00e3n kh\u1edfi ph\u00e1t suy tim, gi\u1ea3m t\u1ef7 l\u1ec7 bi\u1ebfn c\u1ed1 tim v\u00e0 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t. C\u00e1c khuy\u1ebfn ngh\u1ecb \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i (t\u1ee9c l\u00e0, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u LV [LVEF] \u226440%), c\u0169ng nh\u01b0 nguy\u00ean nh\u00e2n c\u1ee7a r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng (v\u00ed d\u1ee5, sau nh\u1ed3i m\u00e1u c\u01a1 tim [MI] ho\u1eb7c c\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c)<\/p>\n

\u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ho\u1eb7c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3) bao g\u1ed3m \u0111\u00e1nh gi\u00e1 LVEF, x\u00e1c \u0111\u1ecbnh xem c\u00f3 ti\u1ec1n s\u1eed ph\u00f9 m\u1ea1ch tr\u01b0\u1edbc \u0111\u00f3 hay kh\u00f4ng v\u00e0 \u0111\u00e1nh gi\u00e1 \u0111i\u1ec7n gi\u1ea3i v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn (nit\u01a1 ur\u00ea m\u00e1u v\u00e0 creatinine huy\u1ebft thanh). \u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed ph\u00f9 m\u1ea1ch v\u00f4 c\u0103n ho\u1eb7c di truy\u1ec1n ho\u1eb7c ph\u00f9 m\u1ea1ch do thu\u1ed1c. \u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c ch\u1eb9n beta bao g\u1ed3m \u0111\u00e1nh gi\u00e1 nh\u1ecbp tim v\u00e0 \u0111o \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 c\u01a1 b\u1ea3n.<\/p>\n

\u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Li\u1ec7u ph\u00e1p \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 mineralocorticoid (MRA) bao g\u1ed3m \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh. Ngo\u00e0i ra, MRA ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea9n th\u1eadn v\u1ec1 nh\u1eefng thay \u0111\u1ed5i c\u1ee7a kali huy\u1ebft thanh v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn.<\/p>\n

2.1. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim (MI) tr\u01b0\u1edbc \u0111\u00f3<\/strong><\/h3>\n

Khuy\u1ebfn ngh\u1ecb \u0111i\u1ec1u tr\u1ecb \u2014<\/strong> \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n m\u1eafc ALVSD kh\u00f4ng c\u00f3 MI tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi LVEF \u226440%:<\/p>\n

    \n
  • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng c\u00f3 NMCT tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi LVEF \u226440%, khuy\u1ebfn ngh\u1ecb \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin (ACE).<\/li>\n
  • Thu\u1ed1c \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II (ARB) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n nh\u01b0ng b\u1ecb ho khi d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed ph\u00f9 m\u1ea1ch.<\/li>\n
  • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng c\u00f3 NMCT tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi LVEF \u226440%, li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf beta.<\/li>\n<\/ul>\n

    B\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n th\u00edch h\u1ee3p kh\u00f4ng c\u00f3 MI tr\u01b0\u1edbc \u0111\u00f3 khi LVEF \u226440%. Trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean , LVEF l\u00e0 \u226435 \u0111\u1ebfn 40%. C\u00e1c khuy\u1ebfn ngh\u1ecb tr\u00ean \u0111\u1ed1i v\u1edbi thu\u1ed1c ch\u1eb9n beta v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n t\u01b0\u01a1ng t\u1ef1 nh\u01b0 khuy\u1ebfn ngh\u1ecb trong h\u01b0\u1edbng d\u1eabn suy tim c\u1ee7a Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3 n\u0103m 2013<\/p>\n

    M\u1ed9t s\u1ed1 chuy\u00ean gia \u1ee7ng h\u1ed9 vi\u1ec7c b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa \u1edf ng\u01b0\u1ee1ng LVEF cao h\u01a1n 40% (t\u1ee9c l\u00e0 v\u1edbi ch\u1ee9c n\u0103ng LV \u00edt b\u1ecb suy gi\u1ea3m nghi\u00eam tr\u1ecdng h\u01a1n) \u1edf nh\u1eefng ng\u01b0\u1eddi th\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh.<\/p>\n

    Qu\u1ea3n l\u00fd \u0111i\u1ec1u tr\u1ecb<\/strong> \u2014 \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n m\u1eafc ALVSD kh\u00f4ng c\u00f3 MI tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi LVEF \u226440 %, th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1eb9n beta, \u0111\u1eb7c bi\u1ec7t v\u00ec b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf men chuy\u1ec3n m\u1ea1nh h\u01a1n.<\/p>\n

    \u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u \u1edf li\u1ec1u th\u1ea5p (v\u00ed d\u1ee5: 5 \u0111\u1ebfn 10 mg lisinopril m\u1ed7i ng\u00e0y) \u0111\u1ec3 gi\u1ea3m kh\u1ea3 n\u0103ng x\u1ea3y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 h\u1ea1 huy\u1ebft \u00e1p v\u00e0 t\u0103ng ure m\u00e1u. Li\u1ec1u \u0111\u01b0\u1ee3c t\u0103ng g\u1ea5p \u0111\u00f4i trong kho\u1ea3ng th\u1eddi gian \u0111\u1ec1u \u0111\u1eb7n (v\u00ed d\u1ee5: c\u1ee9 sau 2 \u0111\u1ebfn 3 tu\u1ea7n \u1edf c\u01a1 s\u1edf \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa) khi \u0111\u01b0\u1ee3c dung n\u1ea1p cho \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c li\u1ec1u m\u1ee5c ti\u00eau. Li\u1ec1u duy tr\u00ec m\u1ee5c ti\u00eau l\u00e0 40 mg lisinopril ho\u1eb7c quinapril m\u1ed7i ng\u00e0y tr\u1eeb khi x\u1ea3y ra t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n

    \u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1eb9n beta \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9nh li\u1ec1u \u00edt nh\u1ea5t \u1edf li\u1ec1u v\u1eeba ph\u1ea3i. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1eb9n beta n\u00ean b\u1eaft \u0111\u1ea7u v\u1edbi li\u1ec1u th\u1ea5p, v\u1edbi li\u1ec1u g\u1ea5p \u0111\u00f4i trong kho\u1ea3ng th\u1eddi gian \u0111\u1ec1u \u0111\u1eb7n (v\u00ed d\u1ee5: c\u1ee9 sau 2 \u0111\u1ebfn 3 tu\u1ea7n \u1edf b\u1ec7nh nh\u00e2n ngo\u1ea1i tr\u00fa) khi \u0111\u01b0\u1ee3c dung n\u1ea1p cho \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c li\u1ec1u m\u1ee5c ti\u00eau. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9nh li\u1ec1u \u0111\u1ebfn li\u1ec1u m\u1ee5c ti\u00eau tr\u01b0\u1edbc ho\u1eb7c sau khi \u0111\u1ea1t \u0111\u01b0\u1ee3c li\u1ec1u m\u1ee5c ti\u00eau c\u1ee7a thu\u1ed1c ch\u1eb9n beta. Li\u1ec1u ban \u0111\u1ea7u v\u00e0 m\u1ee5c ti\u00eau nh\u01b0 sau:<\/p>\n

      \n
    • \u0110\u1ed1i v\u1edbi carvedilol, 3,125 mg hai l\u1ea7n m\u1ed7i ng\u00e0y v\u1edbi li\u1ec1u m\u1ee5c ti\u00eau t\u1eeb 25 \u0111\u1ebfn 50 mg hai l\u1ea7n m\u1ed7i ng\u00e0y (li\u1ec1u cao h\u01a1n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho \u0111\u1ed1i t\u01b0\u1ee3ng tr\u00ean 85 kg).<\/li>\n
    • \u0110\u1ed1i v\u1edbi metoprolol succinate ph\u00f3ng th\u00edch k\u00e9o d\u00e0i, 25 mg m\u1ed7i ng\u00e0y v\u1edbi li\u1ec1u m\u1ee5c ti\u00eau l\u00e0 200 mg\/ng\u00e0y.<\/li>\n
    • \u0110\u1ed1i v\u1edbi bisoprolol, 1,25 mg m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y v\u1edbi li\u1ec1u m\u1ee5c ti\u00eau t\u1eeb 5 \u0111\u1ebfn 10 mg m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y.<\/li>\n<\/ul>\n

      N\u1ebfu li\u1ec1u m\u1ee5c ti\u00eau kh\u00f4ng \u0111\u01b0\u1ee3c dung n\u1ea1p, li\u1ec1u th\u1ea5p c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i v\u00e0 n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/p>\n

      2.2. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n sau nh\u1ed3i m\u00e1u c\u01a1 tim<\/h3>\n

      Khuy\u1ebfn c\u00e1o sau nh\u1ed3i m\u00e1u c\u01a1 tim \u2014<\/strong> Nhi\u1ec1u b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i \u0111\u00e3 t\u1eebng c\u00f3 NMCT c\u00f3 ST ch\u00eanh l\u00ean ho\u1eb7c NMCT kh\u00f4ng ST ch\u00eanh l\u00ean tr\u01b0\u1edbc \u0111\u00f3; ch\u1ec9 \u0111\u1ecbnh ti\u00eau chu\u1ea9n cho \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1eb9n beta sau NMCT \u00e1p d\u1ee5ng cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n

        \n
      • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb NMCT tr\u01b0\u1edbc \u0111\u00f3 , li\u1ec7u ph\u00e1p ch\u1eb9n beta \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng.<\/li>\n
      • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb NMCT tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m nguy c\u01a1 cao (LVEF \u226440%, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ho\u1eb7c b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh \u1ed5n \u0111\u1ecbnh), li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf men chuy\u1ec3n \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng.<\/li>\n
      • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed NMCT kh\u00f4ng c\u00f3 b\u1ea5t k\u1ef3 \u0111\u1eb7c \u0111i\u1ec3m nguy c\u01a1 cao n\u00e0o, c\u00e1c h\u01b0\u1edbng d\u1eabn ch\u00ednh c\u1ee7a c\u00e1c hi\u1ec7p h\u1ed9i \u0111\u1ec1 xu\u1ea5t (khuy\u1ebfn ngh\u1ecb y\u1ebfu) thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n.<\/li>\n
      • \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 t\u1eebng b\u1ecb NMCT c\u00f3 ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n nh\u01b0ng b\u1ecb ho ho\u1eb7c ph\u00f9 m\u1ea1ch khi d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, ARB \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t nh\u01b0 m\u1ed9t gi\u1ea3i ph\u00e1p thay th\u1ebf<\/li>\n
      • Li\u1ec7u ph\u00e1p \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 mineralocorticoid (MRA) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb MI tr\u01b0\u1edbc \u0111\u00f3 m\u00e0 kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1eadn \u0111\u00e1ng k\u1ec3 (\u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 eGFR\u226530 mL\/ph\u00fat tr\u00ean 1,73 m2) ho\u1eb7c t\u0103ng kali m\u00e1u (K+ >5 mEq\/L) \u0111ang d\u00f9ng li\u1ec1u \u0111i\u1ec1u tr\u1ecb c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 thu\u1ed1c ch\u1eb9n beta v\u00e0 c\u00f3 LVEF \u226440%, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ho\u1eb7c suy tim.<\/li>\n<\/ul>\n

        S\u1eed d\u1ee5ng sau nh\u1ed3i m\u00e1u c\u01a1 tim \u2014<\/strong> Thu\u1ed1c ch\u1eb9n beta \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u trong v\u00f2ng 24 gi\u1edd sau khi xu\u1ea5t hi\u1ec7n NMCT c\u1ea5p (ho\u1eb7c mu\u1ed9n h\u01a1n n\u1ebfu c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh s\u1edbm). Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ho\u1eb7c ARB) b\u1eaft \u0111\u1ea7u tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n (\u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m nguy c\u01a1 cao). \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u00eau ch\u00ed \u0111i\u1ec1u tr\u1ecb b\u1eb1ng MRA, vi\u1ec7c b\u1eaft \u0111\u1ea7u tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n<\/p>\n

        3. Qu\u1ea3n l\u00fd r\u1ed1i lo\u1ea1n nh\u1ecbp tim trong r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng\u00a0<\/strong><\/h2>\n

        Trong s\u1ed1 nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng, r\u1ed1i lo\u1ea1n nh\u1ecbp tim n\u00ean \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd theo c\u00e1c h\u01b0\u1edbng d\u1eabn d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng ti\u00eau chu\u1ea9n.<\/p>\n

        C\u00e1c lo\u1ea1i thu\u1ed1c c\u1ea7n tr\u00e1nh \u2014<\/strong> N\u00ean tr\u00e1nh c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y suy tim \u1edf b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng nh\u01b0 thu\u1ed1c ch\u1eb9n k\u00eanh canxi (ngo\u1ea1i tr\u1eeb amlodipine v\u00e0 felodipine) v\u00e0 thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m co b\u00f3p c\u01a1 tim. Ngo\u00e0i ra, m\u1ed9t s\u1ed1 thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp c\u00f3 nguy c\u01a1 g\u00e2y lo\u1ea1n nh\u1ecbp, \u0111\u1eb7c bi\u1ec7t l\u00e0 thu\u1ed1c nh\u00f3m I v\u00e0 thu\u1ed1c nh\u00f3m III ibutilide v\u00e0 sotalol.<\/p>\n

        C\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c n\u00ean tr\u00e1nh ho\u1eb7c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n suy tim n\u00f3i chung c\u0169ng n\u00ean tr\u00e1nh ho\u1eb7c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng.<\/p>\n

        Theo d\u00f5i \u2014 <\/strong>Theo d\u00f5i \u0111\u1ecbnh k\u1ef3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i c\u00f3 th\u1ec3 x\u1ea5u \u0111i v\u00e0 ti\u1ebfn tri\u1ec3n th\u00e0nh suy tim. \u0110\u00e1nh gi\u00e1 si\u00eau \u00e2m tim \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb khi c\u00e1c tri\u1ec7u ch\u1ee9ng suy tim xu\u1ea5t hi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc ALVSD tr\u01b0\u1edbc \u0111\u00f3. Ngo\u00e0i ra, m\u1ed9t s\u1ed1 chuy\u00ean gia \u0111\u1ec1 ngh\u1ecb \u0111\u00e1nh gi\u00e1 si\u00eau \u00e2m tim ti\u1ebfp theo sau kho\u1ea3ng m\u1ed9t n\u0103m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc ALVSD m\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u00e0 v\u1eabn kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. T\u1ea7n su\u1ea5t theo d\u00f5i ti\u1ebfp theo \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi s\u1ef1 \u1ed5n \u0111\u1ecbnh c\u1ee7a LVEF trong qu\u00e1 kh\u1ee9 v\u00e0 kh\u1ea3 n\u0103ng thay \u0111\u1ed5i LVEF s\u1ebd d\u1eabn \u0111\u1ebfn thay \u0111\u1ed5i \u0111i\u1ec1u tr\u1ecb.<\/p>\n","protected":false},"excerpt":{"rendered":"

        R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim. C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu LV kh\u00f4ng tri\u1ec7u ch\u1ee9ng \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c ti\u00eau ch\u00ed kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh […]<\/p>\n","protected":false},"author":60,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nR\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec<\/title>\n<meta name=\"description\" content=\"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.\" \/>\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=\"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-06T08:16:36+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-15T17:47:56+00:00\" \/>\n<meta name=\"author\" content=\"L\u00ea Th\u1ecb \u00c1nh Kim\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u00ea Th\u1ecb \u00c1nh Kim\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/\",\"name\":\"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec\",\"isPartOf\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-06T08:16:36+00:00\",\"dateModified\":\"2023-05-15T17:47:56+00:00\",\"author\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1305c078ca3c2cc0cf032df8e0acf054\"},\"description\":\"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Qu\u1ea3n l\u00fd R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1305c078ca3c2cc0cf032df8e0acf054\",\"name\":\"L\u00ea Th\u1ecb \u00c1nh Kim\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/639579dc40bf605edf728283afa4ebb3?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/639579dc40bf605edf728283afa4ebb3?s=96&d=mm&r=g\",\"caption\":\"L\u00ea Th\u1ecb \u00c1nh Kim\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/kimlethianhgmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec","description":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec","og_description":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/","og_site_name":"Vinmec","article_published_time":"2023-05-06T08:16:36+00:00","article_modified_time":"2023-05-15T17:47:56+00:00","author":"L\u00ea Th\u1ecb \u00c1nh Kim","twitter_card":"summary_large_image","twitter_misc":{"Written by":"L\u00ea Th\u1ecb \u00c1nh Kim","Est. reading time":"9 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/","name":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng - Vinmec","isPartOf":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-05-06T08:16:36+00:00","dateModified":"2023-05-15T17:47:56+00:00","author":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1305c078ca3c2cc0cf032df8e0acf054"},"description":"R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ALVSD) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 suy tim.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/quan-ly-roi-loan-chuc-nang-tam-thu-that-trai-khong-trieu-chung\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Qu\u1ea3n l\u00fd R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i kh\u00f4ng tri\u1ec7u ch\u1ee9ng"}]},{"@type":"WebSite","@id":"https:\/\/noithathoaphat.in\/ctv\/#website","url":"https:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1305c078ca3c2cc0cf032df8e0acf054","name":"L\u00ea Th\u1ecb \u00c1nh Kim","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/639579dc40bf605edf728283afa4ebb3?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/639579dc40bf605edf728283afa4ebb3?s=96&d=mm&r=g","caption":"L\u00ea Th\u1ecb \u00c1nh Kim"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/kimlethianhgmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/32264"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/60"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=32264"}],"version-history":[{"count":2,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/32264\/revisions"}],"predecessor-version":[{"id":34000,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/32264\/revisions\/34000"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=32264"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=32264"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=32264"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}