Mancia G, Giannattasio C, Grassi G
Cattedra di Medicina Interna, Ospedale S. Gerardo, Monza, Università di Milano, Italy.
Am J Hypertens. 1997 Oct;10(10 Pt 2):236S-241S. doi: 10.1016/s0895-7061(97)00329-4.
Congestive heart failure (CHF) is one of the most common and clinically important cardiovascular diseases. This pathologic state is characterized not only by well-defined hemodynamic alterations, but also by complex abnormalities involving the sympathetic nervous system, the renin-angiotensin system, and other hormones involved in cardiovascular homeostasis. In addition, there is an abnormality in the homeostatic cardiovascular control exerted by arterial baroreceptors and the viscoelastic properties of medium-size arteries are altered, causing a reduction in arterial compliance. All of these abnormalities can be favorably affected by angiotensin converting enzyme (ACE) inhibitors, which have been shown to improve not only the hemodynamic and neurohumoral profiles of CHF, but also patient survival. CHF is accompanied with a decline or some sort of effect on renal function. An ACE inhibitor with a dual route of excretion, such as fosinopril, may be especially useful in treating patients with CHF.
充血性心力衰竭（CHF）是最常见且具有重要临床意义的心血管疾病之一。这种病理状态不仅以明确的血流动力学改变为特征，还涉及交感神经系统、肾素 - 血管紧张素系统以及其他参与心血管稳态的激素的复杂异常。此外，动脉压力感受器对心血管稳态的控制存在异常，中动脉的粘弹性特性发生改变，导致动脉顺应性降低。所有这些异常都可被血管紧张素转换酶（ACE）抑制剂有效改善，ACE抑制剂已被证明不仅能改善CHF的血流动力学和神经体液状况，还能提高患者生存率。CHF伴有肾功能下降或某种程度的影响。具有双通道排泄途径的ACE抑制剂，如福辛普利，可能对治疗CHF患者特别有用。
