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充血性心衰的后负荷增加的原因尚不清楚,但实验证据提示肾素——血管紧张素系统在维持外周血管阻力增高有一定作用。8例充血性心衰患者(4例高血压,4例正常血压)于诊断性心导管术时或其后一天,投给了血管紧张素转换酶抑制剂SQ20,881。在阻滞前及阻滞期间进行了各种血流动力学测定,其结果指出,该药可通过减轻后负荷而使所有患者的心功能改善。这种改善与降低总血管阻力有关,而与基础血压及血浆紧素活性无关。这些结果提示,血管紧张素转换酶的抑制是治疗充血性心力衰竭一种有价值的方法,尽管它的确切的作用机理仍不清楚。
The reason for the increased postload of congestive heart failure is unclear, but experimental evidence suggests that the renin-angiotensin system plays a role in maintaining increased peripheral vascular resistance. Eight patients with congestive heart failure (4 with hypertension and 4 with normotensive blood pressure) were given the angiotensin-converting enzyme inhibitor SQ20,881 at or after diagnostic cardiac catheterization. Various haemodynamic determinations were performed before and during blockade, and the results indicate that the drug can improve cardiac function in all patients by reducing postload. This improvement is associated with a decrease in total vascular resistance, but not with basal blood pressure and plasma-type activity. These results suggest that the inhibition of angiotensin-converting enzyme is a valuable method for the treatment of congestive heart failure, although its exact mechanism of action is still unclear.