学术讲座_慢性心力衰竭的临床研究回顾.pptVIP

慢性心力衰竭临床试验的回顾 心力衰竭病生理机制的认识转变 Neuroendocrine Imbalance inHeart Failure ACE Inhibition Prevents Remodelling:SOLVD – Echocardiographic Substudy ACE Inhibition vs Carvedilol:Comparative Pharmacology Carvedilol ACE inhibition (b + a blockade) Neurohormonal modulation SNS RAS RAS SNS Cardiac antiadrenergic + ± ?2 blockade + - ?1 blockade + - Bradykinin/NO - ++ Antioxidant ++ + Apoptosis + +? Anti-ischaemic ++ +? Heart rate reduction + - CARMEN: Rationale Background Carvedilol may have a similar or better profile than ACE inhibition in reversing remodelling and preventing progression of CH