目前,心力衰竭的发病率、死亡率日益增加,因而从不同方面探讨本病的病理生理机制实属必要。在发生心力衰竭的过程中,心肌最初的适应性肥大到随后的不适应性心力衰竭,即从代偿性心肌肥大到失代偿性心力衰竭,这方面的研究越来越受到人们的重视。本文旨在综述与临床有关方面的进展,以提高对发生心力衰竭中心肌肥大的认识。一、心肌肥大的病理生理学分类 (一)压力超负荷型此种类型常常是病理性心肌肥大的最常见原因,然而其对不同心室的影响又迥然不同。在右室泵功能障碍和心力衰竭之前,已观察到肥大心肌每单位肌群的收缩功能降低。另外一个研究发现突然的压力超负荷造成收缩功能降低系暂时的急性损伤,一旦此早期损伤过后,收缩功能可恢复正常。但是,这种突然的压力超负荷实验研究不能适用于人类的临床情况,因为心力衰竭患者心室压力 At present, the morbidity and mortality of heart failure are increasing day by day. Therefore, it is necessary to explore the pathophysiological mechanism of this disease in different aspects. In the process of heart failure, the initial adaptive hypertrophy of myocardium to the subsequent unsuitable heart failure, from compensatory myocardial hypertrophy to decompensated heart failure, more and more attention has been paid to this aspect. This article aims to summarize the progress with the clinical aspects in order to raise awareness of the occurrence of cardiac hypertrophy in heart failure. First, the pathophysiology of myocardial hypertrophy classification (A) pressure overload type This type is often the most common cause of pathological myocardial hypertrophy, however, its impact on different ventricle and very different. Systolic dysfunction per unit muscle mass of hypertrophic myocardium has been observed before right ventricular dysfunction and heart failure. Another study found that sudden stress overload caused a decrease in contractile function to be a temporary acute injury that once contracted back to normal after this early injury. However, this sudden stress overload experimental study can not be applied to human clinical situations, because of heart failure patients with ventricular pressure