African American heart failure trial: Role of endothelial dysfunction and heart failure in African Americans
African American heart failure trial: Role of endothelial dysfunction and heart failure in African Americans
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DOI：
10.1016/j.amjcard.2006.12.013
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发表时间：
2007-03-26
影响因子：
2.8
通讯作者：
Ferdinand, Keith C.
中科院分区：
文献类型：
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作者：
Ferdinand, Keith C.
非裔美国人的心力衰竭（HF）在病因和药物反应方面可能存在差异。与白人冠心病相比，非裔美国人HF的特点是患病率增加、发病较早、住院和死亡风险增加以及高血压作为疾病的潜在原因的患病率增加。在病理生理学和对心脏药物的反应方面存在明显差异。内皮功能障碍可能是该人群中HF的标志之一，其中一氧化氮（NO）释放减少，氧化应激增加导致NO失活增加，抗氧化防御受损。治疗非裔美国人HF的新方法包括使用硝酸异山梨酯联合肼苯哒嗪固定剂量制剂，这可能会影响该人群的内皮功能障碍和NO缺乏的相对作用。非裔美国人心力衰竭试验（A-HeFT）显示发病率和死亡率有所改善，包括住院率降低39%，生活质量或功能状态改善，死亡率降低43%。当添加到标准治疗中时，硝酸异山梨酯和肼苯哒嗪提供了一种基于证据的方法，以降低这一高危人群的发病率和死亡率。(c)2007年爱思唯尔公司All rights reserved.
Heart failure (HF) in African Americans may have differences in etiology and drug response. Compared with coronary disease in whites, HF in African Americans is marked by increased prevalence, earlier onset, increased risk for hospitalization and mortality, and increased prevalence of hypertension as the underlying cause of disease. There are apparent differences in pathophysiology and response to cardiac drugs. Endothelial dysfunction is potentially among the hallmarks of HF in this population, with diminished release of nitric oxygen (NO), increased inactivation of NO caused by increased oxidant stress, and impaired antioxidant defenses. Novel approaches to HF in African Americans include the use of isosorbide dinitrate combined with hydralazine in a fixed-dose formulation, which may affect endothelial dysfunction and the relative contribution of NO deficiency in this population. The African American Heart Failure Trial (A-HeFT) demonstrated improvement in morbidity and mortality, including a 39% reduction in hospitalization, improvement in quality of life or functional status, and a 43% reduction in mortality. When added to standard therapy, isosorbide dinitrate and hydralazine provide an evidence-based, approach to diminishing morbidity and mortality in this high-risk population. (c) 2007 Elsevier Inc. All rights reserved.