Slany J
Wien Klin Wochenschr. 1987 Mar 6;99(5):139-44.
The value of vasodilator drugs in the treatment of patients with chronic congestive heart failure is reviewed on the basis of the randomized double-blind, placebo-controlled trials so far published. Apparently, venous, or combined venous and arteriolar dilation in addition to cardiac glycosides and diuretics may produce long-term improvement in advanced stages of heart failure. Vasodilators with isolated afterload reducing properties seem to be of limited value. Long-term improvement with nitrates and alpha-receptor blocking agents is often modest, probably due to development of tolerance. The most striking results were observed with converting enzyme inhibitors: they evoke virtually no tolerance, improve haemodynamics at rest and during exercise, relieve symptoms of heart failure and are even suggested to reduce mortality.
基于迄今为止发表的随机双盲、安慰剂对照试验，对血管扩张剂药物在慢性充血性心力衰竭患者治疗中的价值进行了综述。显然，除强心苷和利尿剂外，静脉或静脉与小动脉联合扩张可能会使心力衰竭晚期患者获得长期改善。具有单纯降低后负荷特性的血管扩张剂似乎价值有限。硝酸盐类和α受体阻滞剂的长期改善效果通常不明显，这可能是由于耐受性的产生。转换酶抑制剂观察到的结果最为显著：它们几乎不会产生耐受性，能改善静息和运动时的血流动力学，缓解心力衰竭症状，甚至有人认为还能降低死亡率。
