Pfeffer M A
Department of Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA.
Annu Rev Med. 1995;46:455-66. doi: 10.1146/annurev.med.46.1.455.
The loss of myocytes as a consequence of myocardial infarction results in a prompt reduction in regional wall motion and often leads to more protracted and progressive changes in ventricular architecture. The recognition that the process of ventricular enlargement following myocardial infarction is modifiable provided the initial rationale for the use of angiotensin-converting enzyme (ACE) inhibitors as therapy to prevent deterioration in ventricular size and function following infarction. Experimental and clinical studies have documented the effectiveness of this therapy in preventing this late enlargement following infarction. Increasing clinical evidence indicates that this new use of ACE inhibitor therapy in survivors of acute myocardial infarction will lead to an improvement in clinical outcome.
心肌梗死导致的心肌细胞丧失会使局部室壁运动迅速减弱，并常常引发心室结构更持久且渐进性的改变。认识到心肌梗死后心室扩大的过程是可改变的，这为使用血管紧张素转换酶（ACE）抑制剂作为预防梗死后心室大小和功能恶化的治疗方法提供了最初的理论依据。实验和临床研究已证明该疗法在预防梗死后晚期扩大方面的有效性。越来越多的临床证据表明，ACE抑制剂疗法在急性心肌梗死幸存者中的这种新应用将改善临床结局。
