Yancy Clyde W, Laskar Sonjay, Eichhorn Eric
University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9047, USA.
Congest Heart Fail. 2004 Jan-Feb;10(1):34-7. doi: 10.1111/j.1527-5299.2004.02024.x.
The addition of beta-adrenergic antagonists to the treatment regimen for heart failure has validated the neurohormonal hypothesis and provided much-improved outcomes. This benefit had been in question for African Americans based on past experiences in the field of hypertension and worrisome data reported from the Beta Blocker Evaluation of Survival Trial. However, the totality of data now demonstrate that African Americans respond favorably to beta blockers and are capable of having the same outcomes in response to medical therapy for heart failure. There should be no reluctance, nor is there an appropriate rationale, to withhold beta-blocker therapy for heart failure to any patient with left ventricular dysfunction without an overt contraindication. The first prospective trial in African Americans with heart failure, the African American Heart Failure Trial (A-HeFT), is ongoing and provides additional insight into the best treatment strategies for this patient population.
在心力衰竭治疗方案中添加β-肾上腺素能拮抗剂证实了神经激素假说，并带来了显著改善的治疗效果。基于高血压领域过去的经验以及β受体阻滞剂评估生存试验报告的令人担忧的数据，非裔美国人能否从中获益一直存在疑问。然而，目前的全部数据表明，非裔美国人对β受体阻滞剂反应良好，在心力衰竭药物治疗中能够获得相同的治疗效果。对于任何没有明显禁忌证的左心室功能不全患者，不应犹豫使用β受体阻滞剂治疗心力衰竭，也没有合适的理由不使用。针对非裔美国人心力衰竭患者的第一项前瞻性试验——非裔美国人心力衰竭试验（A-HeFT）正在进行中，它为该患者群体的最佳治疗策略提供了更多见解。
