Chaggar Parminder S, Malkin Chris J, Shaw Steven M, Williams Simon G, Channer Kevin S
Northwest Heart and Transplant Centre, Wythenshawe Hospital, Manchester M23 9LT, UK.
Cardiovasc Ther. 2009 Fall;27(3):187-93. doi: 10.1111/j.1755-5922.2009.00094.x.
Chronic heart failure (CHF) involves derangements in multiple neurohormonal axes leading to a procatabolic state and wasting syndrome associated with significant mortality. Catabolic abnormalities include excess catecholamines and glucocorticoids. Anabolic defects include deficiencies of sex steroids, insulin resistance, and growth hormone (GH) resistance. These abnormalities are also correlated with increased morbidity and mortality in CHF. Anabolic axes have been augmented in pilot studies in CHF with testosterone, GH, insulin-like growth factor-1, and GH secretagogues. Results have been varied although some treatments have been associated with improved surrogate endpoints. This review article explores the current understanding of metabolic derangements in CHF and highlights potential neuroendocrine treatment strategies.
慢性心力衰竭（CHF）涉及多个神经激素轴的紊乱，导致分解代谢状态和与显著死亡率相关的恶病质综合征。分解代谢异常包括儿茶酚胺和糖皮质激素过多。合成代谢缺陷包括性类固醇缺乏、胰岛素抵抗和生长激素（GH）抵抗。这些异常也与CHF患者发病率和死亡率增加相关。在CHF的初步研究中，已使用睾酮、GH、胰岛素样生长因子-1和GH促分泌剂增强合成代谢轴。尽管一些治疗与替代终点改善相关，但结果各不相同。这篇综述文章探讨了目前对CHF代谢紊乱的理解，并强调了潜在的神经内分泌治疗策略。
