Patten R D, Udelson J E, Konstam M A
Department of Medicine, New England Medical Center, Boston, MA 02111, USA.
Curr Opin Cardiol. 1998 May;13(3):162-7.
Ventricular remodeling refers to changes in left ventricular (LV) geometry, mass, and volume in response to myocardial injury or alterations in load. The extent of LV dilatation or remodeling after myocardial infarction (MI) or in patients with heart failure is a strong predictor of both morbidity and mortality. Based on these observations, it is clear that LV remodeling is a maladaptive process. Two classes of drugs appear to inhibit LV remodeling. A large amount of data support the use of angiotensin-converting enzyme (ACE) inhibitors to improve survival and to prevent progressive remodeling. In addition, recent studies suggest that beta-adrenergic blockers have a beneficial effect on both survival and remodeling. These data support a causative role of the renin-angiotensin system and perhaps the sympathetic nervous system in this process. Thus, ACE inhibitors and possibly beta-blockers should be part of the pharmacologic regimen for the treatment of patients with LV dysfunction to prevent progressive LV remodeling.
心室重构是指左心室（LV）的几何形状、质量和容积因心肌损伤或负荷改变而发生的变化。心肌梗死（MI）后或心力衰竭患者中左心室扩张或重构的程度是发病率和死亡率的有力预测指标。基于这些观察结果，很明显左心室重构是一个适应不良的过程。两类药物似乎可以抑制左心室重构。大量数据支持使用血管紧张素转换酶（ACE）抑制剂来提高生存率并预防进行性重构。此外，最近的研究表明，β-肾上腺素能阻滞剂对生存率和重构都有有益作用。这些数据支持肾素-血管紧张素系统以及可能交感神经系统在此过程中起因果作用。因此，ACE抑制剂以及可能的β-阻滞剂应成为治疗左心室功能障碍患者以预防进行性左心室重构的药物治疗方案的一部分。
