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[高血压、左心室肥厚与心力衰竭]

[Hypertension, left ventricular hypertrophy and heart failure].

作者信息

Mancia G, Giannattasio C, Grassi G

机构信息

Cattedra di Medicina Interna, Ospedale S. Gerardo dei Tintori di Monza, Università degli Studi di Milano.

出版信息

Ann Ital Med Int. 1993 Oct;8 Suppl:5S-8S.

PMID:8117522
Abstract

Epidemiological and clinical studies carried out over the past 30 years have unequivocally shown that cardiac hypertrophy is frequently associated with high blood pressure values adversely affecting, from a pathophysiological and prognostic view point, the clinical evolution of the hypertensive disease. From a pathophysiological view point, it has been reported that a pathologic increase in cardiac wall thickness not only impairs diastolic function, coronary circulation and reflex control of circulation exerted by cardiopulmonary volume receptors, but also enhances cardiac work and myocardial oxygen consumption. From a clinical view point, cardiac hypertrophy has been shown to increase the risk of occurrence of cardiac arrhythmias, myocardial infarction, heart failure and sudden cardiac death. Antihypertensive drugs, such as ACE-inhibitors, calcium antagonists and alpha and beta-blocking agents, by reducing high blood pressure values and concomitantly by favouring the regression of the echo- and electrocardiographic signs of cardiac hypertrophy, have been shown to physiologically restore normal cardiac function and reflex homeostatic cardiovascular control.

摘要

过去30年进行的流行病学和临床研究明确表明,心脏肥大常与高血压值相关,从病理生理和预后角度来看,这会对高血压疾病的临床进展产生不利影响。从病理生理角度来看,据报道心脏壁厚度的病理性增加不仅会损害舒张功能、冠状动脉循环以及心肺容量感受器对循环的反射控制,还会增加心脏做功和心肌耗氧量。从临床角度来看,心脏肥大已被证明会增加心律失常、心肌梗死、心力衰竭和心源性猝死的发生风险。抗高血压药物,如血管紧张素转换酶抑制剂、钙拮抗剂以及α和β阻滞剂,通过降低高血压值并同时促进心脏肥大的超声心动图和心电图征象的消退,已被证明能在生理上恢复正常心脏功能和反射性心血管稳态控制。

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