Katz A M
Department of Medicine, University of Connecticut, Farmington 06032.
Cardioscience. 1990 Mar;1(1):3-6.
Long-term overloading of the heart gives rise to myocardial abnormalities that play an important role in determining prognosis in patients with congestive cardiac failure. This myocardial response, which can be viewed as a cardiomyopathy of overload, results in part from energy-starvation and altered gene expression in the chronically overloaded heart. The role of vasodilator therapy in reducing symptoms and prolonging life in these patients may be due in part to reduced cardiac energy expenditure; however, the beneficial effects of some vasodilators, notably the converting enzyme inhibitors, may be due to additional effects on the cells of the hypertrophied, failing heart. Improved therapeutic strategies to slow myocardial deterioration in patients with congestive cardiac failure can be expected to come from new knowledge of the pathophysiology, biochemistry and molecular biology of the failing heart.
心脏长期负荷过重会导致心肌异常，这在决定充血性心力衰竭患者的预后方面起着重要作用。这种心肌反应可被视为一种负荷过重性心肌病，部分原因是长期负荷过重的心脏出现能量饥饿和基因表达改变。血管扩张剂疗法在减轻这些患者症状和延长寿命方面的作用，可能部分归因于心脏能量消耗的减少；然而，一些血管扩张剂，尤其是转换酶抑制剂的有益作用，可能归因于对肥厚性衰竭心脏细胞的额外作用。预计通过对衰竭心脏的病理生理学、生物化学和分子生物学的新知识，可以制定出更好的治疗策略来减缓充血性心力衰竭患者的心肌恶化。
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