Katz A M
University of Connecticut School of Medicine, Farmington.
Ann Intern Med. 1994 Sep 1;121(5):363-71. doi: 10.7326/0003-4819-121-5-199409010-00009.
Heart failure is a progressive condition with a 5-year survival of less than 50%. This poor prognosis, which can be reproduced by overloading the hearts of experimental animals, may reflect molecular abnormalities caused when overload stimulates adult cardiac myocytes to undergo hypertrophy. Because these terminally differentiated cells have little or no capacity to divide, hypertrophy represents an unnatural growth response; however, the mechanism by which overload shortens survival remains speculative. Modification of this unnatural growth response by converting enzyme inhibitors and nitrates, which have growth inhibitory as well as vasodilator effects, may contribute to the ability of these drugs to improve prognosis in patients with heart failure.
心力衰竭是一种进行性疾病，5年生存率低于50%。这种不良预后可通过使实验动物心脏负荷过重而再现，可能反映了负荷过重刺激成年心肌细胞发生肥大时所引起的分子异常。由于这些终末分化细胞几乎没有或完全没有分裂能力，肥大代表了一种非自然的生长反应；然而，负荷过重缩短生存期的机制仍属推测。转换酶抑制剂和硝酸盐具有生长抑制及血管舒张作用，通过改变这种非自然生长反应，可能有助于这些药物改善心力衰竭患者的预后。
