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心力衰竭(heart failure,HF)是心室充盈或射血能力受损而引起的一组临床综合征。临床上大多数患者有左心室心肌功能受损及左室射血分数(LVEF)下降的症状。从病理生理学来看,能对心肌收缩、舒张功能,心脏前后负荷任一环节产生影响的因素都可以诱发或加重HF。近年来,关于HF诸方面的研究正越来越引起重视,然而,对于药物与HF的相关关系的研究却不多见。某些药物,如抗肿瘤药物、抗心律失常药物、钙通道阻滞剂、非甾体类抗炎药物等都可通过对心肌细胞直接毒性、产生负性肌力作用、增加心脏负荷不同机制诱发或加重HF。本文将探讨几类能诱发或加重HF的药物及其主要机理,旨在引起广大临床医师的足够重视。
Heart failure (HF) is a group of clinical syndromes caused by impaired ventricular filling or impaired ejection ability. Most patients with clinically impaired left ventricular myocardial function and left ventricular ejection fraction (LVEF) decreased symptoms. From the perspective of pathophysiology, can affect myocardial contractility, diastolic function, heart load before or after any one of the factors that can cause or aggravate HF. In recent years, more and more attention has been paid to the aspects of HF. However, there are few researches on the correlation between drugs and HF. Some drugs, such as anti-tumor drugs, anti-arrhythmic drugs, calcium channel blockers, non-steroidal anti-inflammatory drugs and so on can be directly through the cardiomyocyte toxicity, resulting in negative inotropic effect, increased cardiac load induced by different mechanisms Or increase HF. This article will explore several types of drugs can induce or aggravate HF and its main mechanism, designed to arouse the attention of the majority of clinicians.