浙孚 ZheJiang University Drugs for Treatment of Congestive Heart Failure
Drugs for Treatment of Congestive Heart Failure
Contents J Overview J ACE inhibitors(ACEr) J AT1 receptor blockers(ARB) J mineralocorticoid receptor blockers MRB) u Diuretics B receptor blockers J Cardiac gly coside Others
◼ Overview ◼ ACE inhibitors (ACEI) ◼ AT1 receptor blockers(ARB) ◼ mineralocorticoid receptor blockers(MRB) ◼ Diuretics ◼ receptor blockers ◼ Cardiac glycoside ◼ Others Contents
A. Overview 1. Pathophysiological changes of congestive heart failure(CHF) (1)Function and structure changes neuroendocrine changes (3)Changes of B receptor signal transduction
1. Pathophysiological changes of congestive heart failure (CHF) (1) Function and structure changes (2) Neuroendocrine changes (3) Changes of receptor signal transduction A. Overview
art Failure Inotropes, digoxin Reduced cardiac output 阝- blockers, digoxin Renin Sympathetic nervous Elevated cardia c filling pressures s system activation t k Vasodilators I Angiotensin I Vasoconstriction ACE inhibitors Angiotensin‖l Sodium and water retention ARBs Diuretics Aldosterone Spironolactone Ho2 Cardiac Remodeling
↑ Preload Myocyte loss ↓ Energy supply Cellular Altered collagen hypertrophy matrix afterload Remodelling 小 Cardiac output ↑ Inotropy ↓ Baroreflex Neurohormonal sponse Natriuretic Renin-angiotensin peptides aldosterone Prostaglandins -Sympathetic nervous ↑Ca Arrhythmias Bradyki ↓ Response to system Sudden death Endothelin stress Arginine Fluid& salt tention Vasoconstriction, vascular remodelling, endothelial dysfunction ↑ Peripheral Maintains blood pressure s Perfusion Altered skeletal muscle resistance > Redistributes cardiac output /of vital blood flow and metabolism organs Dyspnea, edema, fatigue