臨床藥理hfppt課件-wenkub.com
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【正文】 341:709 醛固酮受體拮抗劑螺內(nèi)酯 降低充血性心衰病人死亡率 Other Agents with Therapaeutic Potential ? Endothelin1 Antagonists ? The vasoconstrictor peptide, endothelin1, is known to be elevated in heart failure and is a predictor of mortality in patients with heart failure. Animal models of heart failure indicate endothelin receptor antagonists such as bosentan may have longterm benefits in reversing myocardial remodeling and improving survival. Shortterm, smallscale trials in humans indicate possible beneficial effects on systemic and pulmonary hemodynamics ? xanthine oxidase inhibitor ? Background: High serum uric acid (SUA) levels are a strong, independent marker of impaired prognosis in patients with moderate to severe CHF. ? Results and conclusion: Oxypurinol did not produce clinical improvements in unselected patients with moderatetosevere heart failure. However, posthoc analysis suggests that benefits occur in patients with elevated SUA in a manner correlating with the degree of SUA reduction. ? Impact of oxypurinol in patients with symptomatic heart failure. Results of the OPTCHF study. J Am Coll Cardiol 2022。 ? BetaAdrenergic Agonists – dopamine, dobutamine, prenalterol – Levodopa and ibopamine ? Cyclic Nucleotide Phosphodiesterase (PDEIII, cGMPinhibitable PDE) Inhibitors – Bipyridines amrinone and milrinone – imidazolone derivatives enoximone and piroximone BetaBlockers and CHF ? A number of studies beginning in the 1970s have shown that betablockers can improve symptoms and ventricular function in patients with moderate to severe heart failure, and may slow the progression of heart failure in some patients (reviewed in Bristow, Circulation 101:558 (2022)) ? Though betablockers were widely considered to be contraindicated for patients with heart failure only a decade ago, they are now considered firstline therapy for patients with mild to moderate heart failure ? 現(xiàn)認(rèn)為脂溶性的效果更好。含巰基，可致味覺異常。 而不是病馬加鞭 ， 只增強心肌收縮力 心衰的血流動力學(xué)指標(biāo)： 壓力指標(biāo)： LVEDP， 177。 在 CHF的長期發(fā)病過程中 ， 各種代償機制對
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