Singal P K, Siveski-Iliskovic N, Kaul N, Sahai M
Basic Res Cardiol. 1992 Nov-Dec;87(6):512-8. doi: 10.1007/BF00788661.
Natural history of myocardial dysfunction due to chronic contractile deficit consists of physiological and pathophysiological adaptations culminating in congestive heart failure. Among the mechanisms considered is the combination of compensatory as well as the harmful overcompensatory role of the adrenergic system during the genesis of a congestive heart failure "spiral" due to the chronic treatment with adriamycin. Refractoriness of this spiral to various inotropic agents may involve reduced sympathetic support of the myocardium, structural loss of contractile elements and abnormalities of the Ca2+ metabolism.
由于慢性收缩功能缺陷导致的心肌功能障碍的自然病史包括生理和病理生理适应，最终导致充血性心力衰竭。在考虑的机制中，由于阿霉素的长期治疗，在充血性心力衰竭“螺旋”的发生过程中，肾上腺素能系统的代偿作用以及有害的过度代偿作用相互结合。这种“螺旋”对各种正性肌力药物的难治性可能涉及心肌交感支持减少、收缩元件的结构丧失以及钙代谢异常。
