LeJemtel T H, Hochman J S, Sonnenblick E H
Division of Cardiology, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
J Am Coll Cardiol. 1995 Jun;25(7 Suppl):47S-51S. doi: 10.1016/0735-1097(95)00103-b.
When initiated a few days after myocardial infarction, angiotensin-converting enzyme inhibition exerts beneficial effects on survival and morbidity in patients with asymptomatic left ventricular systolic dysfunction or symptomatic heart failure. During the acute phase of a myocardial infarction, angiotensin-converting enzyme inhibition appears to be well tolerated, to prevent the development of heart failure in patients with asymptomatic left ventricular systolic dysfunction and to improve the hemodynamic and clinical variables of heart failure when present. Accordingly, early angiotensin-converting enzyme inhibition is clearly indicated in patients with acute myocardial infarction associated with asymptomatic left ventricular dysfunction or clinical evidence of heart failure. Angiotensin-converting enzyme inhibition may also be beneficial when thrombolytic agents fail to restore coronary patency in patients with acute myocardial infarction.
在心肌梗死后数天开始使用血管紧张素转换酶抑制剂，对无症状左心室收缩功能障碍或有症状心力衰竭患者的生存和发病率具有有益影响。在心肌梗死急性期，血管紧张素转换酶抑制剂似乎耐受性良好，可预防无症状左心室收缩功能障碍患者发生心力衰竭，并在出现心力衰竭时改善其血流动力学和临床指标。因此，对于伴有无症状左心室功能障碍或心力衰竭临床证据的急性心肌梗死患者，早期使用血管紧张素转换酶抑制剂显然是有指征的。在急性心肌梗死患者中，当溶栓药物未能恢复冠状动脉通畅时，血管紧张素转换酶抑制剂可能也有益处。
