Sen S
Am J Med. 1983 Sep 26;75(3A):87-93. doi: 10.1016/0002-9343(83)90124-9.
Regression of cardiac hypertrophy has been proven to occur in experimental animals following some types of antihypertensive therapy. However, no direct and necessary correlation can be found between hypertension and cardiac hypertrophy. The effect of different antihypertensive drugs on regression of cardiac hypertrophy varies despite the same degree of reduction in arterial pressure in hypertensive control subjects. Therapy with alpha-methyldopa resulted in reversal of hypertrophy with effective blood pressure control, whereas treatment with vasodilators, namely hydralazine and minoxidil, either did not alter (hydralazine) degree of myocardial hypertrophy or increase it (minoxidil) despite normalization of blood pressure. The biochemical profile of the myocardium after regression of hypertrophy following antihypertensive therapy is not homogeneous; for example, reversal with alpha-methyldopa is associated with increased collagen content, whereas reversal with Captopril did not alter collagen content of the heart. Adrenergic factors seem to play an important role in the modulation of myocardial structure to variations in arterial pressure. Furthermore, in each type of hypertrophy in hypertension, a combination of different factors might be responsible, and it may not be correct to assume that the same factors must be involved in the regression of all types of myocardial hypertrophy.
在实验动物中,经某些类型的抗高血压治疗后,已证实心脏肥大可发生消退。然而,在高血压与心脏肥大之间找不到直接且必然的关联。尽管高血压对照受试者的动脉压降低程度相同,但不同抗高血压药物对心脏肥大消退的影响各异。使用α-甲基多巴治疗可在有效控制血压的情况下使肥大逆转,而使用血管扩张剂(即肼屈嗪和米诺地尔)治疗,尽管血压恢复正常,但要么未改变(肼屈嗪)心肌肥大程度,要么使其增加(米诺地尔)。抗高血压治疗后心脏肥大消退时心肌的生化特征并不一致;例如,α-甲基多巴使肥大逆转与胶原含量增加有关,而卡托普利使肥大逆转并未改变心脏的胶原含量。肾上腺素能因子似乎在心肌结构对动脉压变化的调节中起重要作用。此外,在高血压的每种肥大类型中,可能由不同因素共同作用导致,认为所有类型的心肌肥大消退都必定涉及相同因素的观点可能并不正确。