Dipro 12e的原文: 「Nitrates and hydralazine were originally combined in the treatment of HFrEF because of their complementary hemodynamic actions. Nitrates, by serving as nitric oxide donors, activate guanylate cyclase to increase cyclic guanosine monophosphate (cGMP) in vascular smooth muscle resulting in venodil...
Dipro 12e的原文: 「Nitrates and hydralazine were originally combined in the treatment of HFrEF because of their complementary hemodynamic actions. Nitrates, by serving as nitric oxide donors, activate guanylate cyclase to increase cyclic guanosine monophosphate (cGMP) in vascular smooth muscle resulting in venodilation and decreased preload. Hydralazine is a direct-acting arterial vasodilator causing a decrease in SVR and resultant increases in SV and CO. However, the beneficial effects of hydralazine and nitrates extend beyond their hemodynamic actions and are likely related to attenuating the biochemical processes driving HF progression.」 「Hydralazine and nitrates should be used in Black patients with persistent symptoms despite GDMT. Hydralazineand a nitrate might be reasonable in patients unable to tolerate either an ACE inhibitor or ARB because of renal insufficiency, hyperkalemia, or possibly hypotension.」