Iyengar Srinivas, Abraham William T
Division of Cardiology, Columbia University Medical Center, New York, NY 10032, USA.
Cardiol Clin. 2008 Feb;26(1):41-8, vi. doi: 10.1016/j.ccl.2007.12.003.
The current treatment paradigm for heart failure revolves around the central theory of neurohormonal antagonism. With the success of angiotensin-converting-enzyme inhibition, beta-blockade, and aldosterone antagonism in heart failure, alternative areas of the hormonal cascade have been targeted for potential benefits. Two such agents, neutral endopeptidase inhibitors and endothelin antagonists, have demonstrated promising initial results in animal models and small, human-based studies but have fallen short when examined in larger clinical trials. The reasons for these shortcomings are varied and require analysis of the design of the studies as well as the intrinsic functions of these agents.
目前心力衰竭的治疗模式围绕神经激素拮抗这一核心理论展开。随着血管紧张素转换酶抑制、β受体阻滞剂和醛固酮拮抗在心力衰竭治疗中取得成功，激素级联反应的其他领域已成为潜在获益的靶点。两种此类药物，即中性内肽酶抑制剂和内皮素拮抗剂，在动物模型和小型人体研究中已显示出有前景的初步结果，但在大型临床试验中进行检验时却未达预期。这些不足的原因多种多样，需要对研究设计以及这些药物的内在功能进行分析。
