血管紧张素II受体阻滞剂缬沙坦在心力衰竭中的作用
Role of the angiotensin II receptor blocker valsartan in heart failure.
作者信息
Webb R L, de Gasparo M
机构信息
Metabolic and Cardiovascular Diseases, Novartis Pharmaceuticals Corporation, Summit, New Jersey, USA; and.
出版信息
Exp Clin Cardiol. 2001 Winter;6(4):215-21.
Despite an enormous amount of research carried out in the past 10 to 20 years, the role of the renin-angiotensin system in the development of heart failure is still not very well understood. This review looks at preclinical data on the role of angiotensin II as a circulating and local hormone, and the effects of stimulation of the respective receptors in heart tissue. Recent large scale clinical trials have begun to furnish evidence of the effects of blocking the renin-angiotensin system in patients with heart failure using angiotensin-converting enzyme inhibitors or, more recently, angiotensin II receptor blockers that act directly at the receptor level, independent of pathways for angiotensin II generation. Results so far indicate that there are benefits from optimizing the blockade, but open questions remain, such as the role of endothelin and bradykinins, and the extent of crosstalk between the different systems.
尽管在过去10到20年里进行了大量研究，但肾素-血管紧张素系统在心力衰竭发展过程中的作用仍未得到很好的理解。本综述着眼于血管紧张素II作为循环激素和局部激素的作用的临床前数据，以及心脏组织中相应受体刺激的影响。最近的大规模临床试验已开始提供证据，证明使用血管紧张素转换酶抑制剂或最近直接作用于受体水平的血管紧张素II受体阻滞剂来阻断肾素-血管紧张素系统对心力衰竭患者的影响，这些药物独立于血管紧张素II生成途径。目前的结果表明，优化阻断有好处，但仍存在一些未解决的问题，如内皮素和缓激肽的作用，以及不同系统之间的相互作用程度。
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