Sigurdsson A, Swedberg K
Department of Medicine, Ostra University Hospital, Göteborg, Sweden.
J Cardiovasc Risk. 1995 Oct;2(5):406-12. doi: 10.1177/174182679500200504.
Ischaemic heart disease is a major cause of chronic heart failure in Western societies. Despite some progress in the treatment of heart failure, it is still a disabling disorder with both high mortality and high morbidity. The incidence of chronic heart failure has increased over the past decade, probably as a result of the recent success in the management of patients with acute myocardial infarction. The importance of measures with potential capacity to prevent the development of symptomatic heart failure may be best illustrated by the fact that, among patients with left ventricular dysfunction, the prognosis is much worse in those with symptomatic failure than in those who are asymptomatic. Recently, the efficacy of angiotensin converting enzyme (ACE) inhibitors after myocardial infarction has been studied in a number of large placebo-controlled trials. These studies indicate that patients with symptomatic or asymptomatic left ventricular dysfunction after an acute myocardial infarction should receive long-term treatment with an ACE inhibitor and that such treatment may improve survival, reduce the incidence of overt heart failure and reduce the risk of reinfarction.
在西方社会，缺血性心脏病是慢性心力衰竭的主要病因。尽管在心力衰竭治疗方面取得了一些进展，但它仍是一种导致残疾的疾病，死亡率和发病率都很高。在过去十年中，慢性心力衰竭的发病率有所上升，这可能是近期急性心肌梗死患者管理取得成功的结果。对于有潜在能力预防症状性心力衰竭发生的措施的重要性，或许可以通过以下事实得到最好的说明：在左心室功能不全的患者中，有症状性心力衰竭的患者预后比无症状患者差得多。最近，在多项大型安慰剂对照试验中研究了心肌梗死后使用血管紧张素转换酶（ACE）抑制剂的疗效。这些研究表明，急性心肌梗死后有症状或无症状左心室功能不全的患者应接受ACE抑制剂长期治疗，而且这种治疗可能会提高生存率、降低显性心力衰竭的发病率并降低再梗死风险。
