记者：I’m an editor of INTERNATION CIRCULATION. I’ll go to ESC and report this meeting for Chinese clinical doctors. Thank you for give me a chance to interview you!
International Circulation is a professional monthly Chinese periodical in cardiology， with Prof. HU Dayi as its Editor in Chief and a hundred cardiologists as its editorial board members. It timely reports worldwide cardiology update in clinical and basic research areas， making in-depth analysis of current trends， focusing on controversies and comments on hot topics in cardiology. Now INTERNATIONAL CIRCULATION has the circulation in 10，000 copies in China Mainland.
As you know， many Chinese doctors couldn’t attend the International Congress， so INTERNATION CIRCULATION has committed itself to bridge the gap. Except for paper， we also has our own online website.

记者：Heart failure is one of the HOT topics in this congress; are there any Updates on this topic?
心衰是今年ESC年会的热点之一，有关心衰有什么新进展？

Professor Faiez Zannad：Yes， well， heart failure…There’re several sections on heart failure in this meeting， but there is no single very important news in heart failure. There are a lot of overviews of what is going on. But one interesting topic is the difference between systolic dysfunction and heart failure with preserved systolic dysfunction. So there is a emerging concept now that it is the same disease with some different degrees of severity. But obviously medications which work on systolic dysfunction would work also in heart failure with diastolic dysfunction. But diastolic dysfunction has not been study extensively. And there are trials which I’m going to be delivering the result in some month of the year. But we have much less evidence based medicine for diastolic heart failure than systolic heart failure. And the second hot topic in this meeting was about BNP.
是的，在这次年会中确实有许多有关心衰的专题，但是并没有什么特别的新进展，主要是一些目前在心衰领域进行的研究现状。但是有一个比较有意思的主题是关于收缩性心功能不全和收缩功能正常的心衰（舒张性心功能不全）的区别。目前的最新的观念认为它们是同一种疾病的不同时期。比较明确的是那些对心脏收缩功能不全有效的药物同样也对心脏舒张功能不全有效。尽管今年会有一些临床研究会被公布，舒展性心功能不全目前还没有得到广泛研究。相对于心脏收缩功能不全，心脏舒张功能不全的实证医学的证据很少。这次会议中另一个热点专题是BNP（brain natriuretic peptide，脑钠素）。

记者：About BNP?
关于BNP。

Professor Faiez Zannad：BNP was now being validated as a tool for prognosis， since this we did know…but which is important that now it is increasingly use this as a diagnosis tool especially in patient with preserved systolic function. A number of patients has signs or symptoms of heart failure which are very unspecific， fatigue， dyspnea， congesting are not specific for heart failure. So you know in order to make the diagnosis of heart failure we need to have the signs and symptoms on the one hand， but also we need to have at least some sort of cardiac involvement. Usually this was done by echocardiography to find out， but still even if echocardiography may miss diastolic dysfunction. And this is the reason BNP may be very helpful in diagnosis heart failure. You know， in Europe there is very large variation in the healthcare systems form one country to another. And for example， in United Kingdom they do not have as many cardiologists as in many other European countries.
我们知道，BNP是一种能够有效预测预后的因子。但是现在我们逐渐认识到，BNP能够作为一种诊断工具，尤其是对那些收缩功能正常的心功能不全患者。很多患者仅有一些诸如恶心、呼吸困难和充血等不特异的心衰症状。在诊断心功能不全的时候，一方面需要依据症状和体征，另一方面至少需要一些心脏被累计的证据。通常可以用超声心动图来寻找心脏被累计的证据，但是即使是超声心动图也可能无法发现舒张性心功能不全。这可能是BNP在诊断心功能不全中可能比较有用的原因之一。你知道在欧洲，各个国家的医疗保健系统之间差别很大。比如英国的心脏病学专家就没有其他欧洲国家多。

Therefore， their heart failure patient do not have echocardiography as frequently as we have that in France or Germany. So UK are lying heavily on BNP. And I believe this message maybe important to china and maybe other place where the number of diagnosis may excess echocardiography. It’s not easy， it’s expensive. But the blood test is much easier. So it may help to diagnosis heart failure. And the second important result when it comes to BNP， the use of BNP as a tool for drug optimization or treatment optimization. A number of patients are discharged after heart failure hospitalization， not been totally stabilized. Because there’s a very big constrain， on the healthcare system， not to keep patient too long in the hospital， it’s very costive. So that increasively patient discharged at the time they are not necessarily totally control. This we cannot know， because we have no objective measure on how well their treat is optimize. BNP is now providing this， so that it indeed if the patient is discharged for example the BNP is still above the 400， we know that the patient is going to come back to be rehospitalized.
因此他们的患者不能像法国或德国的患者那样频繁的使用超声心动图。所以英国更多的依赖BNP。我相信这个信息对中国和其他超声心动不能满足患者群需要的国家比较重要。超声心动相对复杂，也比较昂贵。但是血液检测就比较容易，有助于心功能不全的诊断。BNP的另一个重要作用是用于指导治疗。相当多的因为心功能不全而住院的患者在出院时还没有完全稳定。由于国家医疗保健系统的限制，患者不能长期住院，因为住院费用相当昂贵。越来越多的患者在病情没有完全控制之前就予以出院。因为没有客观的评价治疗效果的指标，我们无法知道确实的结果。而现在BNP能够提供这样的指标。举个例子来说，如果一个患者在出院时候BNP高于400，我们就可以认为这个患者需要回来再次住院。

So there are a lot of resultants of trial which has been published here in this meeting showing that if we use BNP as a tool and to instruct the doctor to take dawn the BNP bellows the level. This is much superior than leaving them with conventional optimization. So BNP as a guide for therapy and as a tool for monitoring drug to optimization is something big new in this meeting. So these are mainly the news in heart failure now caused a number of sections on devices， resynchronization and defibrillation… Although there’s no very news on this area， the discussion is on gross and costly procedure. Because we can see， on European there are very large difference among countries on the rate of implantation. So there are many factors which make some countries implant a number of devices， and other countries are not implanting devices. Although we do have， now， new recommendation which has been released in this meeting on the use of devices in heart failure， which in other recommendation are Class Ia or Ib for certain categories of patient. But still it is not been implemented， there’s a real challenge on getting the health system to integrate this therapy in the management of heart failure patient.

在这次的年会中发表了很多临床试验结果，提示用BNP指导治疗明显优于传统的治疗。用BNP作为客观指标指导临床治疗是这次年会中发布的一个新进展。此外在这次年会的心衰专题中，有很多是关于医疗器械的比如再同步化治疗、除颤器等等。尽管在这个领域其实并没有出现特别创新的内容，主要是有关一些昂贵的器械的讨论。我们可以发现医疗器械的植入率在欧洲各个国家之间有很大差异。有很多因素造成这种差异。这次年会中也对使用器械治疗心衰患者做了一些推荐，主要