Daly P, Rouleau J L, Cousineau D, Burgess J H, Chatterjee K
Br Heart J. 1986 Aug;56(2):152-7. doi: 10.1136/hrt.56.2.152.
Changes in circulating catecholamines and transmyocardial catecholamine balance associated with improved left ventricular function were studied in patients with chronic heart failure after treatment with captopril (10 patients) and hydralazine in combination with isosorbide dinitrate (eight patients). Cardiac performance improved in response to both captopril and hydralazine-nitrate treatment. The systemic haemodynamic effects were also qualitatively similar, but the hydralazine-nitrate combination caused a greater increase in cardiac index and heart rate. Captopril did not change arterial adrenaline concentrations (0.63 to 0.60 nmol/l), arterial noradrenaline (4.2 to 3.9 nmol/l), or net transmyocardial noradrenaline release (390 to 317 pmol/min), while hydralazine-nitrate increased arterial adrenaline (0.91 to 1.47 nmol/l) and transmyocardial noradrenaline release (225 to 554 pmol/min). Although both captopril and hydralazine-nitrate treatment improve left ventricular performance in patients with chronic heart failure, hydralazine-nitrate enhances cardiac sympathetic tone and captopril does not. The clinical relevance of these findings, however, is not known.
在接受卡托普利治疗的慢性心力衰竭患者（10例）以及接受肼屈嗪联合硝酸异山梨酯治疗的患者（8例）中，研究了与左心室功能改善相关的循环儿茶酚胺变化及跨心肌儿茶酚胺平衡。卡托普利和肼屈嗪-硝酸盐治疗均使心脏功能得到改善。全身血流动力学效应在性质上也相似，但肼屈嗪-硝酸盐联合用药使心脏指数和心率有更大幅度的升高。卡托普利未改变动脉血肾上腺素浓度（从0.63降至0.60 nmol/l）、动脉血去甲肾上腺素浓度（从4.2降至3.9 nmol/l）或跨心肌去甲肾上腺素净释放量（从390降至317 pmol/min），而肼屈嗪-硝酸盐使动脉血肾上腺素浓度升高（从0.91升至1.47 nmol/l）以及跨心肌去甲肾上腺素释放量增加（从225升至554 pmol/min）。尽管卡托普利和肼屈嗪-硝酸盐治疗均能改善慢性心力衰竭患者的左心室功能，但肼屈嗪-硝酸盐增强了心脏交感神经张力，而卡托普利则未。然而，这些发现的临床相关性尚不清楚。
