Lechat P
Service de pharmacologie Groupe hospitalier La Pitié, La Salpêtrière, Paris.
Rev Prat. 1997 Dec 1;47(19):2131-4.
Intensive investigations are currently performed in the treatment of cardiac failure, based on the hypothesis of the potentially deleterious effects of compensatory neurohormonal mechanisms. Administration of beta-adrenergic blockers at progressively increasing doses appears well tolerated in most cases, improves left ventricular function and symptoms, and reduces the frequency of hospitalisations for heart failure worsening in patients already receiving a background treatment combining diuretics and an angiotensin converting enzyme inhibitor. Survival improvement remains to be established by the ongoing large scale multicentric trials of beta-blockers. Other therapeutic strategies are investigated, mainly inhibition of angiotensin II and endothelin effects by specific antagonists.
基于代偿性神经激素机制可能产生有害作用的假设，目前在心力衰竭的治疗中进行了深入研究。在大多数情况下，逐步增加剂量使用β受体阻滞剂似乎耐受性良好，可改善左心室功能和症状，并减少已经接受利尿剂和血管紧张素转换酶抑制剂联合基础治疗的患者因心力衰竭恶化而住院的频率。β受体阻滞剂的生存获益仍有待正在进行的大规模多中心试验来证实。正在研究其他治疗策略，主要是通过特异性拮抗剂抑制血管紧张素II和内皮素的作用。
