Morand P, Lavigne G, Masson D, Latour F, Alison D
Arch Mal Coeur Vaiss. 1979 Mar;72(3):268-75.
17 patients with severe chronic heart failure (class III and IV) were prescribed hydralazine, an arterial vasodilatator, orally at doses of 150 mg to 400 mg/day. Considerable clinical improvement was observed in most patients. After 24 to 48 hours the cardiac index rose 79 p. 100, the systolic index by 67 p. 100 and left ventricular work by 73 p. 100, whilst systemic and pulmonary resistances fell by 51 p. 100 and 34 p. 100 respectively. There was no significant change in systemic blood pressure or in heart rate. These results were confirmed at 4 months. Mean pulmonary capillary pressure varied little at the start of treatment but decreased by 52 p. 100 at medium term (4 and 12 months) in this series. No cases of systemic lupus erythematosis were observed. The main, but not the only, indication of therapy with dihydralazine is low output heart failure with little elevation in the pulmonary capillary pressure, especially in primary cardiomyopathy and valvular regurgitation. At present, treatment should be based on the results of cardiac catheterisation and the dosage adjusted according to the rate of hepatic acetylation.
17例重度慢性心力衰竭（Ⅲ级和Ⅳ级）患者口服动脉血管扩张剂肼屈嗪，剂量为每日150毫克至400毫克。多数患者出现了明显的临床改善。24至48小时后，心脏指数上升79%，收缩指数上升67%，左心室作功上升73%，而体循环和肺循环阻力分别下降51%和34%。体循环血压和心率无显著变化。4个月时这些结果得到了证实。在本系列研究中，治疗开始时平均肺毛细血管压变化不大，但在中期（4个月和12个月）下降了52%。未观察到系统性红斑狼疮病例。双肼屈嗪治疗的主要但并非唯一指征是心输出量低且肺毛细血管压升高不明显的心力衰竭，尤其是原发性心肌病和瓣膜反流。目前，治疗应基于心导管检查结果，并根据肝脏乙酰化速率调整剂量。
