Franciosa J A
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
Cardiology. 1988;75 Suppl 1:110-7. doi: 10.1159/000174450.
Vasodilators have gained widespread acceptance in the management of congestive heart failure. They produce prompt hemodynamic and clinical improvement in acute left ventricular failure, and in chronic congestive heart failure they also improve symptoms, functional capacity, and survival. This efficacy, however, is limited to those vasodilators which have venodilating ability, such as nitrates and angiotensin-converting enzyme inhibitors, when they are added to digitalis and diuretics in patients with moderate to severe heart failure. The utility of vasodilators without digitalis or diuretics requires further evaluation. The potential for vasodilators to prevent the development or progression of heart failure from latent to clinically overt disease is also being evaluated.
血管扩张剂在充血性心力衰竭的治疗中已得到广泛认可。它们能迅速改善急性左心室衰竭的血流动力学和临床症状，在慢性充血性心力衰竭中也能改善症状、功能能力并提高生存率。然而，这种疗效仅限于那些具有静脉扩张能力的血管扩张剂，如硝酸盐和血管紧张素转换酶抑制剂，在中重度心力衰竭患者中，当它们与洋地黄和利尿剂合用时。在不使用洋地黄或利尿剂的情况下血管扩张剂的效用需要进一步评估。血管扩张剂预防心力衰竭从潜在疾病发展为临床显性疾病的可能性也正在评估中。
