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一、降低前后负荷作用机制的新认识多年来人们一直认为外周血管床阻力和容量的变化深深地影响着心脏功能。慢性充血性心力衰竭(CNF)的患者,其动脉血管床收缩不当,导致心脏功能进一步恶化。因此,对下述两类病人,人们主张采用长期血管扩张剂治疗:①静脉应用血管扩张剂后患者病情稳定,但7～10天以后,仍不能完全停用者;②尽管采用了强心甙和利尿剂的最佳治疗,症状仍未消失者。近年,有不少心脏病学家对此提出异议,认识到相对性二尖瓣返流(MR)的存在与否对血管扩张剂在慢性CHF中的影响起关键性作用。David等进行了一次研究,给一组
First, to reduce the load before and after the mechanism of new understanding People over the years has been that changes in peripheral vascular bed resistance and capacity have a profound impact on heart function. In patients with chronic congestive heart failure (CNF), the arterial vascular bed is not properly shrunk, resulting in further deterioration of cardiac function. Therefore, the following two types of patients, people advocate the use of long-term vasodilator treatment: ① intravenous vasodilator patients with stable condition, but after 7 to 10 days, still can not be completely disabled; ② despite the use of cardiac glycosides And diuretics best treatment, the symptoms have not disappeared. In recent years, many cardiologists have challenged this, recognizing that the relative presence of mitral regurgitation (MR) plays a key role in the effects of vasodilators in chronic CHF. David et al. Conducted a study for one group