Shah Rena H, Frishman William H
Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.
Cardiol Rev. 2009 May-Jun;17(3):125-31. doi: 10.1097/CRD.0b013e31819f1a98.
Heart failure (HF) remains a major cause of morbidity and mortality, even with the use of standard treatments in patients with chronic HF and acute decompensated HF. Impaired renal function is an important prognostic indicator for adverse clinical outcomes. Elevated plasma levels of adenosine have been observed in HF patients and stimulation of adenosine1 receptors (A1R) in the kidney may be contributing to impaired renal function and treatment resistance. This observation has led to the development of A1R inhibitor drugs, both in oral and intravenous formulations, which in both animal and preliminary clinical trials have been shown to augment diuresis while preserving or improving renal function in HF patients. An extensive phase III clinical program using the A1R KW-3902 is now in progress in patients with symptomatic HF and renal dysfunction to evaluate the efficacy and safety of this treatment approach.
心力衰竭（HF）仍然是发病和死亡的主要原因，即使在慢性HF和急性失代偿性HF患者中使用标准治疗也是如此。肾功能受损是不良临床结局的重要预后指标。在HF患者中观察到血浆腺苷水平升高，肾脏中腺苷1受体（A1R）的刺激可能导致肾功能受损和治疗抵抗。这一观察结果促使了A1R抑制剂药物的研发，包括口服和静脉制剂，在动物和初步临床试验中均显示，这些药物可增加HF患者的尿量，同时维持或改善肾功能。目前，一项使用A1R抑制剂KW-3902的广泛III期临床研究正在有症状HF和肾功能不全患者中进行，以评估这种治疗方法的疗效和安全性。
