醛固酮与慢性心力衰竭

大量临床和实验研究表明,慢性心力衰竭时醛固酮激活促进潴钠排钾、激活交感,并促进心肌和血管外纤维化,是其发生发展的重要病理生理机制。然而长期应用血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ1型受体拮抗剂(ARB)并不能持续、有效地抑制醛固酮(Ald),即存在醛固酮逃逸。而醛固酮受体拮抗剂则具有防止心肌纤维化与心室重塑、抗心律失常作用而降低心力衰竭患者病死率的心血管保护作用,正越来越多地应用于左室功能不良的治疗,成为目前慢性心力衰竭治疗的重要补充。

Aldosterone and Chronic Heart Failure

Lots of experimental and clinical studies have showed that activation of aldosterone can promote retention of sodium and loss of potassimn, activate sympathetic nervous system and promote myocardial and vascular fibrosis, which is the important pathophysiological mechanism in the genesis and development of this diseases. But long-term application of ACEI or ARB can not always inhibit Aid effectively and continuously, which is called escape of aldosterone. Aidosterone receptor antagonist can exert its protective effect on cardiovascular protection by decreasing the case fatality resulting from inhibiting myocardial fibrosis and ventrical remodeling as well as inhibiting arrhythmia, which is more and more applied into the therapy of left ventrical dysfunction and is becoming the important therapeutic replenish of chronic heart failure.