Galvao M
Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY 10461.
Heart Lung. 1990 Sep;19(5 Pt 1):505-11.
Conventional therapy for congestive heart failure (CHF) includes sodium-restricted diet, diuretics, digitalis, vasodilators, and short-term intravenous administration of beta-adrenergic agonists during episodes of decompensation. A specific class of vasodilators, the angiotensin-converting enzyme inhibitors, has recently gained predominance in the treatment of congestive heart failure. The primary mechanism of action is to reduce production of angiotensin II by competitive inhibition of the enzyme that converts angiotensin I into angiotensin II. Reduced levels of angiotensin II, in turn, promote vasodilation and lower aldosterone production. The benefits of angiotensin-converting enzyme inhibitor therapy in chronic congestive heart failure have been demonstrated by improvement in left ventricular performance, exercise capacity, functional status (using New York Heart Association classification), and survival.
充血性心力衰竭（CHF）的传统治疗方法包括限制钠饮食、使用利尿剂、洋地黄、血管扩张剂，以及在失代偿期短期静脉注射β-肾上腺素能激动剂。一类特定的血管扩张剂，即血管紧张素转换酶抑制剂，最近在充血性心力衰竭的治疗中占据了主导地位。其主要作用机制是通过竞争性抑制将血管紧张素I转化为血管紧张素II的酶来减少血管紧张素II的产生。血管紧张素II水平的降低进而促进血管舒张并降低醛固酮的产生。血管紧张素转换酶抑制剂治疗慢性充血性心力衰竭的益处已通过左心室功能、运动能力、功能状态（采用纽约心脏协会分级）的改善以及生存率的提高得到证实。
