Relaxin, a pleiotropic vasodilator for the treatment of heart failure.

Relaxin, a pleiotropic vasodilator for the treatment of heart failure.
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DOI:
10.1007/s10741-008-9129-3
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发表时间:
2009-12
影响因子:
4.6
通讯作者:
Cotter, Gad
Cotter, Gad
中科院分区:
医学2区
文献类型:
--
作者:
Teichman, Sam L.;Unemori, Elaine;Dschietzig, Thomas;Conrad, Kirk;Voors, Adriaan A.;Teerlink, John R.;Felker, G. Michael;Metra, Marco;Cotter, Gad

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松弛素是一种天然存在的肽类激素,在妊娠期间发生的血液动力学和肾血管适应性变化中起核心作用。触发类似的变化可能对心力衰竭患者的治疗有益。松弛素的作用包括产生一氧化氮、抑制内皮素、抑制血管紧张素II、产生VEGF和产生基质金属蛋白酶。这些作用导致全身和肾脏血管扩张、动脉顺应性增加和其他血管变化。认识到这一点导致松弛素用于治疗心力衰竭的研究。一项初步研究显示,心力衰竭患者的血流动力学效果良好,包括心室充盈压降低和心输出量增加。正在进行的RELAX-AHF临床项目旨在评估松弛素对因急性心力衰竭住院的一大群患者的症状和结局的影响。本文将总结松弛素的生物学和数据支持其在人类心力衰竭的潜在疗效。
Relaxin is a naturally occurring peptide hormone that plays a central role in the hemodynamic and renovascular adaptive changes that occur during pregnancy. Triggering similar changes could potentially be beneficial in the treatment of patients with heart failure. The effects of relaxin include the production of nitric oxide, inhibition of endothelin, inhibition of angiotensin II, production of VEGF, and production of matrix metalloproteinases. These effects lead to systemic and renal vasodilation, increased arterial compliance, and other vascular changes. The recognition of this has led to the study of relaxin for the treatment of heart failure. An initial pilot study has shown favorable hemodynamic effects in patients with heart failure, including reduction in ventricular filling pressures and increased cardiac output. The ongoing RELAX-AHF clinical program is designed to evaluate the effects of relaxin on the symptoms and outcomes in a large group of patients admitted to hospital for acute heart failure. This review will summarize both the biology of relaxin and the data supporting its potential efficacy in human heart failure.
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