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Isosorbide dinitrate-hydralazine combination therapy in African Americans with heart failure

机译：亚硝酸异山梨酯-肼苯哒嗪联合治疗心力衰竭的非洲裔美国人

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摘要

Despite significant improvement in therapy and management, heart failure remains a worrisome disease state that is especially problematic in special populations. African Americans suffer a disproportionately higher prevalence of heart failure when compared to other populations. It has been recently demonstrated that vasodilator therapy using the combination of isosorbide dinitrate (ISDN) and hydralazine (HYD) as an adjunct to background evidence-based therapy appears to display the strongest signal of benefit in reducing mortality and morbidity in the African American population. Through review of the retrospective and more recent prospective data, we will focus on the benefit of ISDN-HYD as adjunctive therapy for use in African Americans with systolic heart failure on concomitant appropriate evidence based therapy. This review also closely examines some of the potential contributions to endothelial dysfunction in African Americans, and the relationship of vascular homeostasis and nitric oxide. The role of oxidative stress in left ventricular dysfunction will also be explored as a reduction of oxidative stress offers particular promise in the management of heart failure. Although neurohormonal blockade has been responsible for notable event reductions in patients with systolic heart failure, the addition of ISDN-HYD, vasodilator therapy that enhances nitric oxide and reduces oxidative stress, further improves quality of life and survival in African American patients with heart failure. These findings strongly imply that nitric oxide enhancement and/or oxidative stress reduction may be important new therapeutic directions in the management of heart failure.
机译：尽管在治疗和管理上有显着改善，但心力衰竭仍然是令人担忧的疾病状态，在特殊人群中尤其成问题。与其他人群相比，非裔美国人患心力衰竭的比例高得多。最近已经证明，使用二硝酸异山梨酯（ISDN）和肼屈嗪（HYD）的组合作为背景证据为基础的治疗方法的血管扩张剂治疗似乎显示出在降低非洲裔美国人群死亡率和发病率方面最强的获益信号。通过回顾性研究和最新的前瞻性数据，我们将重点关注ISDN-HYD作为伴随收缩性心力衰竭的非洲裔美国人在伴随适当的循证治疗的基础上使用的辅助治疗的益处。这篇综述还仔细检查了非裔美国人对血管内皮功能障碍的某些潜在作用，以及血管稳态与一氧化氮的关系。氧化应激在左心功能不全中的作用也将被探索，因为氧化应激的减少为心力衰竭的治疗提供了特别的希望。尽管神经激素阻滞导致收缩性心力衰竭患者的事件显着减少，但增加了ISDN-HYD（血管扩张剂疗法）可增强一氧化氮并减少氧化应激，进一步改善了非洲裔美国人心力衰竭患者的生活质量和生存率。这些发现强烈暗示一氧化氮的增加和/或氧化应激的减少可能是心力衰竭治疗中重要的新治疗方向。

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    Echols, Melvin R; Yancy, Clyde W;

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  • 年度 2006
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  • 正文语种 {"code":"en","name":"English","id":9}
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