Marti Catherine, Cole Robert, Kalogeropoulos Andreas, Georgiopoulou Vasiliki, Butler Javed
Emory University Hospital, Atlanta, GA 30322, USA.
Curr Heart Fail Rep. 2012 Mar;9(1):1-7. doi: 10.1007/s11897-011-0072-6.
Diuretics and vasodilators have been the cornerstone of heart failure (HF) therapy for decades. Although not shown to reduce mortality, diuretic and vasodilator therapy remain commonplace for treating acute decompensated HF, with diuretics being the mainstay of therapy for the removal of excess fluid in all patients with HF. This article discusses results of recent trials concerning diuretic or vasodilator therapy and HF, including the Diuretic Optimization Strategies Evaluation (DOSE) trial, the Placebo-Controlled Randomized Study of the Selective A1 Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function (PROTECT), and the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST), as well as results from the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial and the Preliminary Study of Relaxin in Acute Heart Failure (Pre-RELAX-AHF).
几十年来，利尿剂和血管扩张剂一直是心力衰竭（HF）治疗的基石。尽管未显示出能降低死亡率，但利尿剂和血管扩张剂疗法在治疗急性失代偿性HF中仍然很常见，利尿剂是所有HF患者清除多余液体的主要治疗方法。本文讨论了近期有关利尿剂或血管扩张剂疗法与HF的试验结果，包括利尿剂优化策略评估（DOSE）试验、选择性A1腺苷受体拮抗剂罗氟司特用于急性失代偿性心力衰竭合并容量超负荷住院患者以评估对充血和肾功能治疗效果的安慰剂对照随机研究（PROTECT）、托伐普坦在心力衰竭结局研究中的血管加压素拮抗疗效（EVEREST），以及奈西立肽在失代偿性心力衰竭中的临床有效性急性研究（ASCEND-HF）试验和急性心力衰竭中松弛素的初步研究（Pre-RELAX-AHF）的结果。
