Medical therapy of chronic heart failure. Role of ACE inhibitors and beta-blockers.
Heart failure has long been considered to have a progressive downhill course leading inexorably to an early demise. This course often occurs silently, in the absence of any obvious cardiac insults. The reason for this is a combination of cell loss, myocyte dysfunction, impaired energetics, and pathologic remodeling of the chamber. Improved clinical outcome should result from strategies that reduce the biologic signals responsible for myocyte growth, dysfunction, and loss and chamber remodeling. Clinicians should no longer attempt to treat chronic heart failure with pharmacologic growth and remodeling process. In time, it may be possible for the clinician to view the treatment of heart failure largely as a matter of improving the biologic function of the myocardium.
Eichhorn
E J
EJ
Department of Internal Medicine (Cardiology Division), University of Texas Southwestern, Dallas, USA. Eichhorn@Ryburn.SWMED.EDU
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000804:Angiotensin II / Q000502:physiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D015536:Down-Regulation; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D009206:Myocardium / Q000473:pathology; D009638:Norepinephrine / Q000502:physiology; D012084:Renin-Angiotensin System; D020257:Ventricular Remodeling
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000804:Angiotensin II; D009638:Norepinephrine