Pitt Bertram
University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Cardiol Clin. 2008 Feb;26(1):15-21, v. doi: 10.1016/j.ccl.2007.12.016.
Aldosterone blockade has been shown to be effective in reducing mortality in patients who have severe heart failure because of systolic left ventricular dysfunction (SLVD) and those who have heart failure and SLVD post-myocardial infarction. Aldosterone blockade also may be beneficial in patients who have New York Heart Association class II heart failure, asymptomatic left ventricular dysfunction, and heart failure with preserved or normal left ventricular function. Considering the beneficial effects of aldosterone blockade on improving nitric oxide availability, endothelial function, and atherosclerosis, it can also be postulated that an aldosterone blockade would add to the benefits of an angiotensin-converting enzyme inhibitor in patients who have coronary artery disease. However, these hypotheses must be confirmed in well-designed, large-scale, prospectively randomized studies.
醛固酮拮抗剂已被证明可有效降低因左心室收缩功能障碍（SLVD）导致严重心力衰竭的患者以及心肌梗死后出现心力衰竭和SLVD患者的死亡率。醛固酮拮抗剂对纽约心脏协会II级心力衰竭、无症状左心室功能障碍以及左心室功能保留或正常的心力衰竭患者也可能有益。考虑到醛固酮拮抗剂在改善一氧化氮可用性、内皮功能和动脉粥样硬化方面的有益作用，还可以推测，醛固酮拮抗剂会增加冠状动脉疾病患者使用血管紧张素转换酶抑制剂的益处。然而，这些假设必须在精心设计、大规模、前瞻性随机研究中得到证实。
