Drawing Boundaries around PARADISE.
Drawing Boundaries around PARADISE.
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围绕天堂划定界限。
DOI：
10.1056/nejme2115471
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
DeFilippis,AndrewP
中科院分区：
文献类型：
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作者：
Stevenson,LynneW;DeFilippis,AndrewP
“战斗或逃跑”系统进化为支持人类应对急性生理威胁，这种威胁现在比慢性心血管压力更不常见。交感神经系统和肾素-血管紧张素-醛固酮系统（RAAS）的进行性激活有助于慢性心力衰竭，包括急性心肌梗死后发生的心力衰竭。药物抑制RAAS可改善心脏结构、功能和预后。此外，利钠肽系统现在被认为对RAAS提供平衡，增强利钠和血管舒张，同时减少纤维化和细胞凋亡。Neprilysin是一种锌依赖的中性内肽酶，可降解20多种肽，包括利钠肽、血管紧张素II、内皮素-1和缓激肽，并受到抑制。
Fight-or-flight systems evolved to support humans through acute physiological threats that are now less common than chronic cardiovascular stress. Progressive activation of the sympathetic nervous system and the renin–angiotensin–aldosterone system (RAAS) contributes to chronic heart failure, including that which occurs after acute myocardial infarction. Pharmacologic inhibition of the RAAS improves cardiac structure, function, and outcomes. In addition, the natriuretic peptide system is now recognized to provide counterbalance to the RAAS, enhancing natriuresis and vasodilation while decreasing fibrosis and apoptosis. Neprilysin, a zinc-dependent neutral endopeptidase, degrades more than 20 peptides, including natriuretic peptides, angiotensin II, endothelin-1, and bradykinin, and is inhibited . . .