Riegger G A, Muders F, Luchner A
Klinik und Poliklinik für Innere Medizin II, Universität Regensburg.
Z Kardiol. 1996;85 Suppl 6:205-10.
In the early phase of asymptomatic left ventricular dysfunction, neurohumoral systems are activated and are closely associated with the deterioration of left ventricular function and the progression into symptomatic heart failure. Congestive cardiac failure is characterized by an increasing activation of the sympathetic nerve activity, the renin angiotensin aldosterone system, vasopressin and endothelin. Together with a reduced endothelial formation of NO, the activation of neurohumoral systems leads to vaso-construction and retention of sodium and water, and by this, to a deterioration of cardiac function. On the other side, systems are activated like prostaglandins, ANP, BNP, dopamine and bradykinin, which act as vasodilators and increase natriuresis and diuresis. In the early phase of cardiac failure, natriuretic and vasodilator mechanisms are able to counteract vasoconstrictor factors, preventing by this unfavorable effects on left ventricular function.
在无症状性左心室功能障碍的早期阶段，神经体液系统被激活，并与左心室功能的恶化以及进展为有症状的心力衰竭密切相关。充血性心力衰竭的特征是交感神经活动、肾素-血管紧张素-醛固酮系统、血管加压素和内皮素的激活增加。随着内皮细胞一氧化氮生成减少，神经体液系统的激活导致血管收缩以及钠和水潴留，进而导致心脏功能恶化。另一方面，前列腺素、心房利钠肽、脑钠肽、多巴胺和缓激肽等系统被激活，它们作为血管舒张剂，增加尿钠排泄和利尿作用。在心力衰竭的早期阶段，利钠和血管舒张机制能够抵消血管收缩因子的作用，从而防止对左心室功能产生不利影响。
