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慢性充血性心力衰竭(CHF)是以心室功能和神经内分泌调节异常为特征,伴有运动耐力下降和液体潴留的临床综合征。尽管交感神经紧张性增加和肾素血管紧张素系统激活,使CHF患者血管扩张性下降,但内皮是调节局部组织灌注的关键因素,实验和临床研究均显示CHF存在内皮功能障碍,其内皮依赖性血管舒张明显受损,CHF的内皮功能障碍通过外周效应使全身外周阻力增高,后负荷增加,并通过中心效应如心肌缺血及诱导型一氧化氮合酶引发的损害效应加重心功能损害。临床研究显示其内皮功能受损程度与CHF严重性密切相关,改善内皮功能可增加CHF运动耐力和心排出量,因此,成为治疗CHF的新方向。
Chronic congestive heart failure (CHF) is a clinical syndrome characterized by abnormal ventricular function and neuroendocrine regulation with decreased exercise tolerance and fluid retention. In spite of the increased sympathetic tone and the activation of the renin-angiotensin system, the vasodilatation of CHF patients is decreased, but the endothelium is the key factor regulating local tissue perfusion. Both experimental and clinical studies show that endothelial dysfunction exists in CHF and its endothelium-dependent Vasodilation is markedly impaired. Endothelial dysfunction in CHF increases peripheral systemic resistance through peripheral effects, increases postload, and impairs cardiac function impairment through central effects such as damage induced by myocardial ischemia and inducible nitric oxide synthase. Clinical studies have shown that the degree of endothelial dysfunction is closely related to the severity of CHF, and improvement of endothelial function can increase exercise tolerance and cardiac output of CHF, thus becoming a new direction for the treatment of CHF.