Follath F
Departement Innere Medizin, Universitätsspital Zürich.
Ther Umsch. 2000 May;57(5):321-3. doi: 10.1024/0040-5930.57.5.321.
In most large scale trials the prognosis of ischemic heart failure is worse than in patients with non-ischemic etiology. The therapeutic effect of essential drugs such as ACE-inhibitors, betablockers and diuretics is similar, but response to some other drugs (amiodarone, amlodipine, digoxin, growth hormone) is better in non-ischemic heart failure. Of great practical importance is the recognition of hibernating myocardium in coronary artery disease, since revascularisation may significantly improve left ventricular function. Specific therapeutic interventions are possible in hypertensive heart disease, alcoholic cardiomyopathy and LV-dysfunction to tachyarrhythmias. The etiology of heart failure should therefore be cleared in all patients.
在大多数大规模试验中,缺血性心力衰竭的预后比非缺血性病因患者更差。血管紧张素转换酶抑制剂、β受体阻滞剂和利尿剂等基本药物的治疗效果相似,但非缺血性心力衰竭患者对其他一些药物(胺碘酮、氨氯地平、地高辛、生长激素)的反应更好。认识冠心病中的冬眠心肌具有重要的实际意义,因为血运重建可能显著改善左心室功能。对于高血压性心脏病、酒精性心肌病和左心室功能不全伴快速性心律失常,有特定的治疗干预措施。因此,所有心力衰竭患者都应明确病因。