Mason D T
Schweiz Med Wochenschr. 1978 Nov 4;108(44):1695-703.
The vasodilators produce disparate modifications of cardiac function depending on the differing alterations of preload versus impedance: nitrates principally cause venodilation; nitroprusside, phentolamine and prazosin produce balanced arterial and venous dilation; while hydralazine predominantly effects arterial dilation. Combined nitroprusside and dopamine or dobutamine synergistically enhance low cardiac output and decrease raised left ventricular end-diastolic pressure. Ambulatory oral vasodilator therapy is provided by long-acting nitrates, hydralazine and prazosin alone, combined nitrate-hydralazine and combined prazosin-hydralazine. It is truly remarkable how quickly systemic vasodilators have become established as an important new medical advance in acute and chronic congestive heart failure treatment. In the future, as more experience is gained with the vasodilators and as newer such agents become available, the systemic vasodilators likely will be utilized as often as digitalis in the standard treatment of congestive heart failure.
硝酸盐主要引起静脉扩张；硝普钠、酚妥拉明和哌唑嗪可使动脉和静脉均衡扩张；而肼屈嗪主要作用于动脉扩张。硝普钠与多巴胺或多巴酚丁胺联合使用可协同增强低心输出量并降低升高的左心室舒张末期压力。长效硝酸盐、单独使用的肼屈嗪和哌唑嗪、联合使用的硝酸盐 - 肼屈嗪以及联合使用的哌唑嗪 - 肼屈嗪可提供门诊口服血管扩张剂治疗。全身血管扩张剂如此迅速地成为急性和慢性充血性心力衰竭治疗中的一项重要新医学进展，着实令人瞩目。未来，随着对血管扩张剂的经验积累增多以及更多新型此类药物问世，全身血管扩张剂在充血性心力衰竭的标准治疗中可能会像洋地黄一样经常被使用。
