Cohn J N
Department of Medicine, University of Minnesota Medical School, Minneapolis.
J Cardiovasc Pharmacol. 1989;14 Suppl 9:S55-8.
After acute myocardial infarction, left ventricular filling pressure is elevated because of systolic and/or diastolic dysfunction. The severity of the left ventricular dysfunction is influenced not only by infarct size and location but also by biochemical, neurohormonal, and peripheral vascular responses to infarction. Short-term vasodilator therapy improves left ventricular dysfunction and may influence favorably long-term prognosis in the presence of severe systolic dysfunction but not with predominant diastolic dysfunction. The chronic systolic dysfunction which may follow acute myocardial infarction also is influenced favorably by chronic vasodilator therapy.
急性心肌梗死后,由于收缩和/或舒张功能障碍,左心室充盈压升高。左心室功能障碍的严重程度不仅受梗死面积和部位的影响,还受梗死的生化、神经激素及外周血管反应的影响。短期血管扩张剂治疗可改善左心室功能障碍,在存在严重收缩功能障碍时可能对长期预后产生有利影响,但对以舒张功能障碍为主的情况则不然。急性心肌梗死后可能出现的慢性收缩功能障碍也可因慢性血管扩张剂治疗而得到改善。