Sharpe Norman
Curr Heart Fail Rep. 2004 Apr-May;1(1):9-13. doi: 10.1007/s11897-004-0011-x.
Clinical research during the past several decades has shown the importance of cardiac remodeling as a basic mechanism in the progression of heart failure. Changes in cardiac remodeling have high concordance with long-term clinical outcomes. Cardiac remodeling should be regarded as a primary target for treatment and also can serve as a reliable surrogate for clinical outcomes. Neurohormonal blockade with combination treatments that inhibit the renin-angiotensin-aldosterone and sympathetic systems has proven effective in improving cardiac remodeling and clinical outcomes. Such treatment should be standard therapy for patients with left ventricular dysfunction after myocardial infarction and patients with chronic heart failure.
过去几十年的临床研究表明，心脏重塑作为心力衰竭进展的一种基本机制具有重要意义。心脏重塑的变化与长期临床结局高度一致。心脏重塑应被视为治疗的主要靶点，也可作为临床结局的可靠替代指标。采用抑制肾素-血管紧张素-醛固酮系统和交感神经系统的联合治疗进行神经激素阻断已被证明可有效改善心脏重塑和临床结局。这种治疗应成为心肌梗死后左心室功能不全患者和慢性心力衰竭患者的标准治疗方法。
