Inoue Koichi, Hori Masatsugu
Department of Internal Medicine and Therapeutics, Osaka University, Graduate School of Medicine.
Nihon Rinsho. 2003 May;61(5):862-6.
Ischemic heart failure is induced by myocardial ischemia, which is probably the commonest cause of left ventricular systolic dysfunction. Theoretically, there are two main strategies to treat the patients with ischemic heart failure; to retard progression of the dysfunction, and to relief and prevent myocardial ischemia. The management with angiotensin converting enzyme(ACE) inhibitor and beta-blocker improve the prognosis of ischemic heart failure by enhancing the left ventricular function and preventing coronary event. Spironolactone also seems to improve their prognosis. In contrast, treatments directed specifically at coronary arteries, such as antithrombotic agents and revascularization, have not been proven to be effective and safe to these patients yet. Large scale clinical trials are currently underway investigating the effect of treatment, such as aspirin, warfarin, clopidogrel and revascularization which are targeted to the coronary syndrome.
缺血性心力衰竭由心肌缺血诱发,心肌缺血可能是左心室收缩功能障碍最常见的原因。理论上,治疗缺血性心力衰竭患者有两种主要策略:延缓功能障碍的进展,以及缓解和预防心肌缺血。使用血管紧张素转换酶(ACE)抑制剂和β受体阻滞剂进行治疗可通过增强左心室功能和预防冠状动脉事件来改善缺血性心力衰竭的预后。螺内酯似乎也能改善其预后。相比之下,专门针对冠状动脉的治疗方法,如抗血栓药物和血运重建,尚未被证明对这些患者有效且安全。目前正在进行大规模临床试验,以研究针对冠状动脉综合征的治疗效果,如阿司匹林、华法林、氯吡格雷和血运重建。