Creager M A
Brigham and Women's Hospital, Harvard Medical School, Boston.
Drugs. 1990;39 Suppl 4:4-9; discussion 22-4. doi: 10.2165/00003495-199000394-00003.
Treatment for patients with congestive heart failure is primarily directed at reducing symptoms and improving functional capacity. In patients with moderate to severe heart failure, therapeutic interventions incorporating diuretics, digoxin and selected vasodilators, specifically angiotensin-converting enzyme (ACE) inhibitors, are designed to correct pathophysiological mechanisms such as left ventricular dysfunction, excessive vasoconstriction and renal reabsorption of sodium and water. Physician-investigators are turning their attention to identifying and treating patients early in the course of their disease. Vasodilator therapy in patients with mild symptoms of heart failure may not only improve exercise performance, but also reduce mortality. In addition, recent studies have suggested that ACE inhibitors may prevent progression of disease in patients with asymptomatic left ventricular dysfunction. It is hoped that ongoing research will demonstrate that early identification and treatment of these patients may prevent development of symptoms and improve survival.
充血性心力衰竭患者的治疗主要旨在减轻症状并提高功能能力。对于中重度心力衰竭患者，采用利尿剂、地高辛和特定血管扩张剂（特别是血管紧张素转换酶（ACE）抑制剂）的治疗干预措施，旨在纠正诸如左心室功能障碍、过度血管收缩以及钠和水的肾重吸收等病理生理机制。内科医生研究人员正将注意力转向在疾病过程早期识别和治疗患者。心力衰竭症状较轻患者的血管扩张剂治疗不仅可以改善运动能力，还可降低死亡率。此外，最近的研究表明，ACE抑制剂可能会阻止无症状左心室功能障碍患者疾病的进展。人们希望正在进行的研究将证明，对这些患者的早期识别和治疗可能会预防症状的出现并提高生存率。
