心力衰竭是一種復雜的臨床綜合征,是各種心臟病的嚴重階段,其發病率高、住院率和死亡率也居高不下。這是一種以癥狀為主的疾病,特定的癥狀包括呼吸困難和乏力,并常伴有體液潴留等特定體征。此外,心力衰竭還表現為進行性過程。
初始的心肌損傷會導致血流動力學異常(如前負荷、后負荷及心肌收縮力的改變影響心臟做功)。盡管改善這些參數可以顯著減輕癥狀,但對心力衰竭的發展、長期預后和死亡率并無實質幫助。近年來,逐漸明確導致心力衰竭發生和發展的重要機制是心室重塑,具體表現為:心肌細胞肥大、凋亡及胚胎基因與蛋白質的重新表達;心肌細胞外基質的質量與組成變化。
臨床表現為心肌質量增加、心室容積擴大和心室形狀改變。初始的心肌損傷后,多種內源性神經內分泌因子被激活,包括去甲腎上腺素、血管緊張素Ⅱ、醛固酮、加壓素、內皮素以及腫瘤壞死因子等。在心力衰竭狀態下,這些因子的循環和組織水平均升高,并通過長期慢性激活促使心肌重塑,加劇心肌損傷與功能惡化,從而形成惡性循環。
因此,阻斷神經內分泌系統及心肌重塑成為治療心力衰竭的關鍵環節,受到越來越多的關注,并不斷出現新的治療設想及藥物。
| 中文名稱 | 英文名稱 | CAS號 | 化學式 |
|---|---|---|---|
| 黃夾苷 | Thevetin | 11018-93-2 | C42H66O18 |
| 高根二醇 | k-strophanthin-β | 560-53-2 | C36H54O14 |
| 米屈肼 | meldonium | 76144-81-5 | C6H14N2O2 |
| 米力農 | 1,6-dihydro-2-methyl-6-oxo-(3,4'-bipyridine)-5-carbonitrile | 78415-72-2 | C12H9N3O |
| 洋地黃毒苷 | digitoxin | 71-63-6 | C41H64O13 |
| 氨力農 | amrinone | 60719-84-8 | C10H9N3O |
| 毛花苷C | lanatoside C | 17575-22-3 | C49H76O20 |
| 毒毛花苷K | K-Strophanthin | 11005-63-3 | C39H60O13 |
| 布福吉寧 | resibufogenin | 465-39-4 | C24H32O4 |
| 左西孟旦 | simendan | 131741-08-7 | C14H12N6O |
| 左旋西孟旦 | levosimendan | 141505-33-1 | C14H12N6O |
| 奧普力農 | olprinone | 106730-54-5 | C14H10N4O |
| 去乙酰毛花苷 | Deslanoside | 17598-65-1 | C47H74O19 |
| 乳酸米力農 | 2-hydroxypropanoate;6-methyl-2-oxo-5-pyridin-4-yl-1H-pyridine-3-carbonitrilium | 100286-97-3 | C15H15N3O4 |
| 中文名稱暫缺 | acetyldigitoxin | 1111-39-3 | C43H66O14 |
| G毒毛旋花苷 | ouabain | 630-60-4 | C29H44O12 |
| —— | [(2R,3R,4S,6S)-3-hydroxy-6-[(2R,3S,4S,6S)-4-hydroxy-6-[(2R,3S,4S,6R)-4-hydroxy-6-[[(3S,5R,8S,9R,10S,13R,14S,17R)-14-hydroxy-10,13-dimethyl-17-(5-oxo-2H-furan-3-yl)-1,2,3,4,5,6,7,8,9,11,12,15,16,17-tetradecahydrocyclopenta[a]phenanthren-3-yl]oxy]-2-methyloxan-3-yl]oxy-2-methyloxan-3-yl]oxy-2-methyloxan-4-yl] acetate | 1111-39-3 | C43H66O14 |
| —— | digitoxin | 71-63-6 | C41H64O13 |
| —— | digitoxin | 71-63-6 | C41H64O13 |
| —— | digitoxin | 71-63-6 | C41H64O13 |
| —— | digitoxin | 71-63-6 | C41H64O13 |
| —— | Kombetin | 630-60-4 | C29H44O12 |
| —— | [(3R,4R)-6-[(3S,4R)-6-[(3S,4R)-6-[[12,14-dihydroxy-10,13-dimethyl-17-(5-oxo-2H-furan-3-yl)-1,2,3,4,5,6,7,8,9,11,12,15,16,17-tetradecahydrocyclopenta[a]phenanthren-3-yl]oxy]-4-hydroxy-2-methyloxan-3-yl]oxy-4-hydroxy-2-methyloxan-3-yl]oxy-2-methyl-3-[(3S,4R,5S)-3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxyoxan-4-yl] acetate | 17575-22-3 | C49H76O20 |
| —— | 4-[(1R,3R,5S,8R,9S,10R,11R,13R,14S,17R)-1,5,11,14-Tetrahydroxy-10-hydroxymethyl-13-methyl-3-((2R,3R,4R,5R,6S)-3,4,5-trihydroxy-6-methyl-tetrahydro-pyran-2-yloxy)-hexadecahydro-cyclopenta[a]phenanthren-17-yl]-5H-furan-2-one | 630-60-4 | C29H44O12 |
| —— | Ouabain | 630-60-4 | C29H44O12 |
| —— | ouabain | 630-60-4 | C29H44O12 |
| —— | Lanatosid C | 17575-22-3 | C49H76O20 |
| —— | Digimed | 71-63-6 | C41H64O13 |
| —— | Digilanide C | 17575-22-3 | C49H76O20 |
| —— | Strophanthin | 11005-63-3 | C36H54O14 |
| —— | 5-(3-Hydroxy-10,13-dimethyl-hexadecahydro-20-oxa-cyclopropa[14,15]cyclopenta[a]phenanthren-17-yl)-pyran-2-one | 62859-81-8 | C24H32O4 |