Opie L H
Medical Research Council Ischaemic Heart Disease Research Unit, University of Cape Town Medical School, South Africa.
Cardiovasc Drugs Ther. 1994 May;8 Suppl 2:297-304. doi: 10.1007/BF00877313.
Ischemic left ventricular (LV) dysfunction includes a number of discrete entities, such as acute LV failure in angina, acute myocardial infarction, and ischemic cardiomyopathy. Recently, new entities have arisen to expand the spectrum of ischemic LV function. These include postinfarct diastolic dysfunction, stunning, hibernation, and preconditioning. The tantalizing possibility exists that several of these states can coexist. There are widely differing underlying pathophysiologic states. Hence it is not easy to be dogmatic about whether a given group of therapeutic agents, such as the calcium antagonists, may be beneficial in ischemic LV dysfunction. Nonetheless, there is experimental evidence that calcium antagonists may benefit the specific entity of stunning and clinical evidence that they benefit postinfarct ischemic LV diastolic dysfunction. These agents, as a group, should be evaluated in reperfusion and postinfarct dysfunctional syndromes.
缺血性左心室（LV）功能障碍包括一些不同的情况，如心绞痛、急性心肌梗死和缺血性心肌病中的急性左心室衰竭。最近，出现了一些新情况，扩大了缺血性左心室功能的范围。这些包括梗死后舒张功能障碍、心肌顿抑、心肌冬眠和预处理。存在几种这些状态可能共存的诱人可能性。存在广泛不同的潜在病理生理状态。因此，对于一组特定的治疗药物，如钙拮抗剂，是否可能对缺血性左心室功能障碍有益，很难教条地做出判断。尽管如此，有实验证据表明钙拮抗剂可能对心肌顿抑这一特定情况有益，也有临床证据表明它们对梗死后缺血性左心室舒张功能障碍有益。作为一个整体，这些药物应该在再灌注和梗死后功能障碍综合征中进行评估。
