Dawson Adelle, Struthers Allan D
Department of Clinical Pharmacology Therapeutics, University of Dundee, Ninewells Hospital, Dundee, Scotland.
J Renin Angiotensin Aldosterone Syst. 2002 Sep;3(3):156-9. doi: 10.3317/jraas.2002.035.
Considerable attention has recently focused on the vasopeptidase inhibitors (VPI), a new class of drug that combines angiotensin-converting enzyme (ACE) inhibitor activity with inhibition of natriuretic peptide breakdown. In theory, a drug with these properties may be beneficial both in hypertension and in heart failure. Whilst the efficacy of VPIs in hypertension has been consistently demonstrated in pre-clinical and clinical studies, the role of VPIs, if any, in heart failure is less clear, since numerous small studies have produced conflicting results. Furthermore, preliminary results from the recently completed Omapatrilat Versus Enalapril Randomised Trial of Utility in Reducing Events (OVERTURE) study have failed to establish the VPI, omapatrilat, as a first line therapy in the treatment of chronic heart failure. We review the literature on VPIs in heart failure and discuss possible reasons for the reported lack of benefit over ACE inhibitors.
最近，相当多的关注集中在血管肽酶抑制剂（VPI）上，这是一类新型药物，它将血管紧张素转换酶（ACE）抑制剂活性与利钠肽分解抑制作用结合在一起。从理论上讲，具有这些特性的药物可能对高血压和心力衰竭都有益处。虽然VPI在高血压中的疗效已在临床前和临床研究中得到一致证明，但VPI在心力衰竭中的作用（如果有的话）尚不清楚，因为众多小型研究得出了相互矛盾的结果。此外，最近完成的奥马曲拉与依那普利降低事件发生率随机效用试验（OVERTURE）研究的初步结果未能确立VPI奥马曲拉作为治疗慢性心力衰竭的一线疗法。我们回顾了关于VPI在心力衰竭中应用的文献，并讨论了报告显示其相对于ACE抑制剂缺乏益处的可能原因。
