VAI TRÒ BẢO VỆ
CỦA THUỐC ỨC CHẾ MEN CHUYỂN
TRONG CHUỖI BỆNH LÝ TIM MẠCH
GS.TS. NGUYỄN LÂN VIỆT
(Viện Tim mạch Việt Nam)
CHUOÃI BEÄNH LYÙ TIM MAÏCH (Cardiovascular continuum)
theo Dzau & Braunwald
Voøng xoaén beänh lyù –
Cô sôû sinh lyù beänh cuûa chuoãi beänh lyù tim maïch
From
J Am Coll Cardiol
2001;37:975-84.
Endothelial damage
Mechanical fatigue
Atherosclerosis
Central aortic pressures
Pulse pressure
Central wave
reflection
Large arteries
stiffening
Pathophysiological
continuum
T¸c ®éng cña Angiotensin II trong
c¸c m« kh¸c nhau
Direct vasopressor
effect
Fibroblast
and myocyte
hypertrophy
and proliferation
Increased
peripheral
vascular
resistance
Angiotensin II
Aldosterone
Sodium and
fluid retention
Expansion of
intravascular
volume
Raised
blood
pressure
Vascular wall
thickening
Cardial hypertrophy
Vai trß cña thuèc øc chÕ men chuyÓn trong
viÖc h¹n chÕ sù HìNH thµnh ANGIOTENsin II
Kallikrein
ACE
Kiniase II
Renin
Kininogen Bradykinin Angiotensin I Angiotensinogen
Prostaglandins
EDRF
Inactive peptides
Cardiovascular effects
Vasodilator
Endothelial protective
Antithrombotic
ACE
INHIBITORS
Angiotensin II
Cardiovascular effects
Vasoconstrictor
Profilerative
Hypertrophic
Prothrombotic (PAI-1)
++
++
–
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