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充血性心力衰竭(CHF)患者不同程度地存在着下述恶势螺旋:由于心室充盈压(VFP)的升高所引起的进行性心脏增大,严重的瘀血症状,二尖瓣返流加剧和心输出量的下降,以及体循环动、静脉血管阻力的加剧进一步使泵血功能降低;且存在肾上腺素β_1受体的“减数调节作用”和前负荷的明显增加,使衰竭心肌处于F ranK-Starling曲线的平坦段。心脏负荷状况的变化直接影响心力衰竭患者的心输出量(C O),随着周围血管阻力的下降,心脏泵血功能将明显提高;.VFP的适度下降仅使CO轻度降低,但瘀血症状将明显得到改善。兼具降低前后负荷的药物可使二尖瓣和主动脉瓣关闭不全患者的返流血量减少,并增加前向搏出
Patients with congestive heart failure (CHF) have varying degrees of the following descending spiral: progressive heart enlargement due to increased ventricular filling pressure (VFP), severe blood stasis symptoms, increased mitral regurgitation And decreased cardiac output, as well as systemic and venous vascular resistance further exacerbated the pumping function decreased; and the presence of adrenergic β 1 receptor “regressive effect” and a significant increase in pre-load, so that failure of the myocardium in F ranK -Starling curve of the flat section. Cardiac output changes directly affect the cardiac output in patients with heart failure (CO), with the decline in peripheral vascular resistance, cardiac pump function will be significantly improved ;. The moderate decline in VFP only to a slight decrease in CO, but the symptoms of blood stasis Will be significantly improved. Both reduce the load of drugs before and after the mitral valve and aortic valve regurgitation can reduce the volume of patients with reflux and increase the forward stroke