DeWald Tracy A, Hernandez Adrian F
Division of Clinical Pharmacology, Duke University Medical Center, Box 3943 Medical Center, Durham, NC 27710, USA.
Expert Rev Cardiovasc Ther. 2010 Feb;8(2):159-69. doi: 10.1586/erc.09.173.
Acute decompensated heart failure is a common clinical problem with associated poor outcomes. Over the last decade, attention to this area has greatly increased, with a focus on medical therapies that may safely offer improvement in acute symptoms and early outcomes. Previous therapies that focused on increased inotropy have generally failed to improve symptoms without adverse consequences. Thus, attention towards vasodilators and natriuretic peptides, such as nesiritide, has increased owing to nesiritide's symptomatic improvement and unique mechanism of improvement in hemodynamics. However, the pathophysiology of acute decompensated heart failure is complex and the impact of nesiritide on important clinical end points, beyond symptomatic and hemodynamic improvement, is unknown.
急性失代偿性心力衰竭是一个常见的临床问题，预后较差。在过去十年中，对这一领域的关注大幅增加，重点是可能安全改善急性症状和早期预后的药物治疗。以往专注于增强心肌收缩力的治疗通常未能改善症状且无不良后果。因此，由于奈西立肽能改善症状且具有独特的血流动力学改善机制，对血管扩张剂和利钠肽（如奈西立肽）的关注有所增加。然而，急性失代偿性心力衰竭的病理生理学很复杂，奈西立肽对重要临床终点的影响（除症状和血流动力学改善外）尚不清楚。
