时间和技术将会证明：心力衰竭中神经激素调节的病理生理基础。
Time and technology will tell: the pathophysiologic basis of neurohormonal modulation in heart failure.
作者信息
Reed Brent N, Street Sarah E, Jensen Brian C
机构信息
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, MD 21201, USA.
Department of Cell Biology and Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
出版信息
Heart Fail Clin. 2014 Oct;10(4):543-57. doi: 10.1016/j.hfc.2014.07.002. Epub 2014 Aug 14.
Abstract
The central roles of neurohormonal abnormalities in the pathobiology of heart failure have been defined in recent decades. Experiments have revealed both systemic involvement and intricate subcellular regulation by circulating effectors of the sympathetic nervous system, the renin-angiotensin-aldosterone system, and others. Randomized clinical trials substantiated these findings, establishing neurohormonal antagonists as cornerstones of heart failure pharmacotherapy, and occasionally offering further insight on mode of benefit. This review discusses the use of β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone receptor antagonists in the treatment of heart failure, with particular attention to the pathophysiologic basis and mechanisms of action.
摘要
近几十年来，神经激素异常在心力衰竭病理生物学中的核心作用已得到明确。实验揭示了交感神经系统、肾素-血管紧张素-醛固酮系统及其他循环效应因子的全身参与及复杂的亚细胞调节。随机临床试验证实了这些发现，确立了神经激素拮抗剂作为心力衰竭药物治疗的基石，并偶尔对获益模式提供了进一步的见解。本综述讨论了β受体阻滞剂、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和醛固酮受体拮抗剂在心力衰竭治疗中的应用，特别关注其病理生理基础和作用机制。
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