Kubo S H
Cardiovascular Division University of Minnesota, Minneapolis 55455.
Circulation. 1990 Feb;81(2 Suppl):III107-14.
The neurohormonal vasoconstrictor systems are frequently activated in patients with congestive heart failure, and they make important contributions to characteristic abnormalities in vasoconstriction. In 177 patients with congestive heart failure, however, there was a widespread distribution of levels of plasma renin activity and plasma norepinephrine, indicating that activation of the renin-angiotensin system and the sympathetic nervous system was not uniform. Furthermore, there were only weak correlations between plasma renin activity and plasma norepinephrine and hemodynamic measurements, age, and renal function, indicating that activation of these systems is complex and determined by many other factors. The converting enzyme inhibitors have beneficial effects on the hemodynamic abnormalities of patients with heart failure, with reductions in arterial tone and preload as well as increases in cardiac output. Their long-term effects on markers of the renin-angiotensin system, however, and their interactions with the sympathetic nervous system and atrial natriuretic factor are less well defined.
神经激素性血管收缩系统在充血性心力衰竭患者中经常被激活，它们对血管收缩的特征性异常起重要作用。然而，在177例充血性心力衰竭患者中，血浆肾素活性和血浆去甲肾上腺素水平分布广泛，这表明肾素-血管紧张素系统和交感神经系统的激活并不一致。此外，血浆肾素活性与血浆去甲肾上腺素以及血流动力学测量、年龄和肾功能之间仅有微弱的相关性，这表明这些系统的激活是复杂的，且由许多其他因素决定。转换酶抑制剂对心力衰竭患者的血流动力学异常具有有益作用，可降低动脉张力和前负荷，并增加心输出量。然而，它们对肾素-血管紧张素系统标志物的长期影响以及它们与交感神经系统和心房利钠因子的相互作用尚不清楚。
