心力衰竭中的冠状动脉血流动力学及治疗干预的效果。
Coronary hemodynamics in heart failure and effects of therapeutic interventions.
作者信息
Chatterjee Kanu
机构信息
Division of Cardiology, Moffitt-Long Hospital, University of California, San Francisco, CA 94143-0124, USA.
出版信息
J Card Fail. 2009 Mar;15(2):116-23. doi: 10.1016/j.cardfail.2009.01.001.
BACKGROUND
The abnormalities in coronary hemodynamics in systolic heart failure are frequent. Myocardial oxygen demand and consumption are increased and myocardial perfusion is also impaired, which may result in myocardial ischemia, necrosis, and apoptosis. This is potentially a contributing factor for progressive heart failure.
METHODS AND RESULTS
Neurohormonal abnormalities such as activated renin-angiotensin-aldosterone system, increased adrenergic activity, hemodynamic abnormalities such as decreased left ventricular perfusion pressure, and increased left ventricular diastolic pressure are important mechanisms for myocardial ischemia.
CONCLUSIONS
Different pharmacologic agents may exert different effects on coronary hemodynamics although changes in systemic hemodynamics may be similar. Some agents may enhance myocardial ischemia and others may decrease it. Thus, an understanding of changes in coronary hemodynamics may have therapeutic implications.
背景
收缩性心力衰竭患者常出现冠状动脉血流动力学异常。心肌需氧量和耗氧量增加，心肌灌注也受损，这可能导致心肌缺血、坏死和凋亡。这可能是导致心力衰竭进展的一个潜在因素。
方法与结果
神经激素异常，如肾素-血管紧张素-醛固酮系统激活、肾上腺素能活性增加，血流动力学异常，如左心室灌注压降低和左心室舒张压升高，是心肌缺血的重要机制。
结论
尽管全身血流动力学变化可能相似，但不同的药物制剂对冠状动脉血流动力学可能产生不同的影响。一些药物可能会加重心肌缺血，而另一些药物可能会减轻心肌缺血。因此，了解冠状动脉血流动力学的变化可能具有治疗意义。
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