Pousset F, Isnard R, Komajda M
Hôpital La Pitié-La Salpêtrière, Paris.
Arch Mal Coeur Vaiss. 2002 Feb;95 Spec 4(5 Spec 4):27-32.
The decisive therapeutic advances achieved in cardiac insufficiency in recent years have been thanks to drugs affecting the different neurohormonal systems in operation. Neurohormonal activation plays a major role in cardiac insufficiency. Several neuro-endocrine mechanisms exert vasoconstrictor effects: the sympathetic system, the renin-angiotensin-aldosterone system and the endothelins. In cardiac insufficiency these effects are counterbalanced, but insufficiently, by vasodilatory agents, mainly the natiuretic peptides, EDRF (endothelium derived relaxing factor), vasodilatory prostaglandins, bradykinin and adrenomedulin. Neurohormonal activation is an excellent marker of not only the severity but also the prognosis of cardiac insufficiency. Standardisation of dosage is desirable in order to allow the use of neurohormonal drugs in a very large number of centres.
近年来在心脏功能不全治疗方面取得的决定性进展得益于作用于不同运行中的神经激素系统的药物。神经激素激活在心脏功能不全中起主要作用。几种神经内分泌机制发挥血管收缩作用：交感神经系统、肾素 - 血管紧张素 - 醛固酮系统和内皮素。在心脏功能不全中，这些作用主要通过利钠肽、内皮衍生舒张因子（EDRF）、血管舒张性前列腺素、缓激肽和肾上腺髓质素等血管舒张剂来平衡，但平衡不足。神经激素激活不仅是心脏功能不全严重程度的良好指标，也是其预后的良好指标。为了能在大量中心使用神经激素药物，剂量标准化是很有必要的。
