kÄ±sÄ±m 1 temel kalp yetersizliÄi - Rasim Enar

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170 KANITA DAYALI KALP YETERSİZLİĞİ KİTABI Renal perfüzyonda bozulma RAAS stimulasyonu Miyokardiyal yetersizlik Sodyum reabsorbsiyonu Atriyal veya ventriküler distansiyon veya ikiside ANP salınımı Kalp yetersizliği Renal perfüzyonda bozulma İdrarda sodyum: Potasyum oranı Kompanse Hafif-orta >1.0 Dekompanse Orta-ciddi
Nörohormonal Kalp Yetersizliği ve Sol Ventrikülün Yeniden Biçimlenmesi (Remodeling) 171 şimler, konjestif <strong>kalp</strong> yetersizliğinin tedavisinde önemli bir unsurdur. Bu hastalarda ACEİ nin yararlılığı onaylanmıştır. Anjiotensin reseptor antagonistlerinin de aynı şekilde ispatlanmıştır. • Son olarak RALES çalışması, konjestif <strong>kalp</strong> yetersizliği hastalarında ACEİ ve kıvrım diüretikleri ile kombine edilen aldosteron reseptor antagonistlerinin etkinliğini gösteren güçlü kanıtlar sağlamıştır. KAYNAKLAR 1. Davis JO. The physiology of congestive heart failure. In: Hamilton WF, ed. Handbook of physiology: a critical, comprehensive presentation of physiological knowledge and concepts. Section 2. Circulation. Vol. 3. Washington, D.C.: American Physiological Society, 1965:2071-122. 2. Coppage WS Jr, Island DP, Cooner AE, Liddle GW. The metabolism of aldosterone in normal subjects and in patients with hepatic cirrhosis. J Clin Invest 1962;41:1672-80. 3. Luetscher JA Jr, Johnson BB. Observations on the sodiumretaining corticoid (aldosterone) in the urine of children and adults in relation to sodium balance and edema. J Clin Invest 1954;33:1441-6. 4. Weber KT, Brilla CG. Pathological hypertrophy and cardiac interstitium:fibrosis and renin-angiotensin-aldosterone system. Circulation 1991;83:1849-65. 5. Struthers AD. Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in chronic heart failure. J Card Fail 1996;2:47-54. 6. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999;341:709-17. 7. Harris P. Evolution and the cardiac patient. Cardiovasc Res 1983;17:373-8. 8. Smith HW. Renal physiology. In: Fishman AP, Richards DW, eds. Circulation of the blood: men and ideas. New York: Oxford University Press, 1964:545-606. 9. Harris P. Evolution and the cardiac patient. Cardiovasc Res 1983;17:437-45. 10. Nishimura H. Comparative endocrinology of renin and angiotensin. In: Johnson JA, Anderson RR, eds. The reninangiotensin system. Vol. 130 of Advances in experimental medicine and biology. New York: Plenum Press, 1980:29-77. 11. Villarreal D, Freeman RH. ’Til death do us part: a case of failed affection. Cardiovasc Res 1995;30:27-30. 12. Cohen EL, Conn JW, Rovner DR. Postural augmentation of plasma renin activity and aldosterone excretion in normal people. J Clin Invest 1967;46:418-28. 13. Tobian L. Interrelationship of electrolytes, juxtaglomerular cells and hypertension. Physiol Rev 1960;40:280-312. 14. Silva P, Brown RS, Epstein FH. Adaptation to potassium. Kidney Int 1977;11:466-75. 15. Sealey JE, Laragh JH. The renin–angiotensin–aldosterone system for normal regulation of blood pressure and sodium and potassium homeostasis. In: Laragh JH, Brenner BM, eds. Hypertension: pathophysiology, diagnosis, and management. 2nd ed. Vol. 2. New York: Raven Press, 1995: 1763-96. 16. Liddle GW. Physiology of aldosterone. In: Addison GM, Wirenfeldt Asmussen N, Corvol P, et al., eds. Aldosterone antagonists in clinical medicine. Amsterdam: Excerpta Medica, 1978:91-7. 17. Okubo S, Niimura F, Nishimura H, et al. Angiotensin-independent mechanism for aldosterone synthesis during chronic extracellular fluid volume depletion. J Clin Invest 1997;99:855-60. 18. Vaughan DE, Lazos SA, Tong K. Angiotensin II regulates the expression of plasminogen activator inhibitor-1 in cultured endothelial cells: a potential link between the renin-angiotensin system and thrombosis. J Clin Invest 1995;95: 995-1001. 19. Weber KT. Hormones and fibrosis: a case for lost reciprocal regulation. News Physiol Sci 1994;9:123-8. Okunulması Tavsiye Edilen Kaynaklar 20. Weber KT. Aldosterone ın congestive heart failure.NEJM 2001;345 1689-97 21. Krishna K. Gaddam M, Eduardo P, Saima H, and David AC.Aldosterone and Cardiovascular Disease. Curr Probl Cardiol 2009;34:51-84. 22. Thierry HL, Claudia S. Vasopressin dysregulation: Hyponatremia, fluid retention and congestive heart failure. International Journal of Cardiology 120 (2007) 1–9 23. Jessup M, Brozena S. Heart Failure. N Engl J Med 2003;348: 2007-18.
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