Nitrate Therapy for Heart Failure Benefits and Strategies to Overcome Tolerance

被引：23

作者：

Gupta, Divya ^{[1
]}

Georgiopoulou, Vasiliki V. ^{[1
]}

Kalogeropoulos, Andreas P. ^{[1
]}

Marti, Catherine N. ^{[1
]}

Yancy, Clyde W. ^{[2
]}

Gheorghiade, Mihai ^{[2
]}

Fonarow, Gregg C. ^{[3
]}

Konstam, Marvin A. ^{[4
]}

Butler, Javed ^{[1
]}

机构：

[1] Emory Univ, Div Cardiol, Atlanta, GA 30322 USA

[2] Northwestern Univ, Div Cardiol, Chicago, IL 60611 USA

[3] Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA

[4] Tufts Univ, Div Cardiol, Boston, MA 02111 USA

来源：

JACC-HEART FAILURE | 2013年 / 1卷 / 03期

关键词：

heart failure; hydralazine; nitrate; pseudotolerance; renin angiotensin aldosterone system; tolerance;

D O I：

10.1016/j.jchf.2013.03.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Combination therapy with hydralazine and nitrates can improve outcomes in patients with heart failure and low ejection fraction. However, this combination is underused in clinical practice for several reasons, including side effects related to hydralazine and polypharmacy. Some of the benefits seen with hydralazine, including afterload reduction and attenuation of nitrate tolerance, have also been observed with angiotensin-converting enzyme inhibitors. Demonstrating similar clinical benefits with nitrates plus angiotensin-converting enzyme inhibitor therapy alone, in the absence of hydralazine, may represent an opportunity to improve heart failure care by increasing the use of nitrates. In this paper, we summarize data that support studying such an approach. (c) 2013 by the American College of Cardiology Foundation

引用

页码：183 / 191

页数：9

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