Metra Marco, Nodari Savina, Dei Cas Livio
Cardiologia, Universita di Brescia, 25123, Italy.
J Renin Angiotensin Aldosterone Syst. 2004 Sep;5 Suppl 1:S11-6. doi: 10.3317/jraas.2004.018.
Treatment of heart failure has undergone major changes in the last two decades. European and US guidelines have absorbed these major changes and set the new standards. It is therefore mandatory that treatment of heart failure is based on this knowledge. According to these guidelines, patients with chronic symptomatic heart failure should be treated with a diuretic and sometimes digoxin and vasodilators, to relieve symptoms, in addition to an angiotensin-converting enzyme inhibitor and/or an angiotensin receptor blocker (ARB) and a beta-blocker to improve prognosis. An aldosterone antagonist should be added in patients with more advanced heart failure. Prevention of heart failure has also become a major goal. We summarise here the major issues regarding the pharmacological treatment of chronic heart failure as indicated by the European and US guidelines.
在过去二十年中，心力衰竭的治疗发生了重大变化。欧洲和美国的指南吸纳了这些重大变化并设定了新标准。因此，心力衰竭的治疗必须基于这些知识。根据这些指南，慢性症状性心力衰竭患者除了应使用血管紧张素转换酶抑制剂和/或血管紧张素受体阻滞剂（ARB）以及β受体阻滞剂来改善预后外，还应使用利尿剂，有时还需使用地高辛和血管扩张剂来缓解症状。对于病情更严重的心力衰竭患者，应加用醛固酮拮抗剂。心力衰竭的预防也已成为一个主要目标。在此，我们总结欧洲和美国指南中指出的关于慢性心力衰竭药物治疗的主要问题。
