New therapeutic options in congestive heart failure: Part I
New therapeutic options in congestive heart failure: Part I
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DOI：
10.1161/01.cir.0000014763.63528.9d
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发表时间：
2002-04-30
期刊：
影响因子：
37.8
通讯作者：
Pfeffer, MA
中科院分区：
文献类型：
--
作者：
McMurray, J;Pfeffer, MA
CHF是指血运重建术是否能显著改善冬眠区患者的左室收缩功能。[20]休眠的定义和检测休眠的最佳方法在其他地方进行了广泛的讨论。[19 - 21]迄今为止，关于CHF患者中重要心肌冬眠的流行率的数据很少。尽管一些小的病例系列描述了血运重建对此类患者左室功能的影响，但尚未以任何系统的方式研究此类治疗的结果。幸运的是，北美和欧洲的试验正在进行中（见下文）。急性冠状动脉事件增加了CHF患者死亡和住院的风险，并伴有心力衰竭恶化。22 ACE抑制剂和阻断剂可能通过减少冠状动脉事件部分发挥其有益作用。23 - 25抗血小板治疗也可以这样做，尽管阿司匹林的作用是有争议的（见下文）。虽然HMG-CoA还原酶抑制剂（他汀类药物）尚未在CHF患者中进行专门研究，但它们也可能会减少冠状动脉事件，就像它们在其他冠状动脉疾病患者中所做的那样。
CHF is whether revascularization might substantially improve LV systolic function in patients with significant areas of hibernation. 20 The definition and best means of detecting hibernation are discussed extensively elsewhere. 19–21 There are, as yet, few data on the prevalence of important myocardial hibernation in patients with CHF. Although some small case series describe the effect of revascularization on LV function in such patients, the results of this type of treatment have not been studied in any systematic way. Fortunately, North American and European trials are getting under way (see below).Acute coronary events increase the risk of death and hospitalization with worsening heart failure in patients with CHF. 22 ACE inhibitors and-blockers may exert their beneficial effects in part by reducing coronary events. 23–25 Antiplatelet therapy may do likewise, although the role of aspirin is controversial (see below). Although HMG-CoA reductase inhibitors (statins) have not been specifically studied in patients with CHF, they might also be expected to reduce coronary events, as they do in other patients with coronary artery disease.