Nikolić V, Planinc D, Rudar M, Pagon L
Wien Med Wochenschr. 1987 Jan 15;137(1):9-13.
25 patients are presented with chronic cardiomyopathy (NYHA class IV), who were refractory to conventional digitalis and diuretics treatment which was administered over at least 3 weeks. The patients were split in 2 groups: the first group consisted of 10 patients who were haemodynamically monitored while being administered nitroprusside for 24 hours. After the treatment, the cardiac index significantly increased (by 36%), left ventricular filling pressure decreased (by 48%), and systemic vascular resistance fell (by 47%). The second group, consisting of 15 patients, was administered prazosin in addition to conventional treatment. The effects of prazosin were clinically monitored. After 3 weeks of continual prazosin treatment, the clinical condition of 12 patients was improved to NYHA class II whereas the condition of the other 3 was improved only to NYHA class III. During further treatment this improvement was maintained. The effects of the treatment can be easily followed and assessed on the basis of clinical features, so that other, more complex methods of follow-up are not required. The results of our study show that patients with refractory heart failure can be safely administered prazosin without previous assessment of haemodynamic parameters.
25例患有慢性心肌病（纽约心脏协会IV级）的患者，对至少持续3周的常规洋地黄和利尿剂治疗无效。这些患者被分为两组：第一组由10名患者组成，在给予硝普钠治疗24小时期间进行血流动力学监测。治疗后，心脏指数显著增加（36%），左心室充盈压降低（48%），全身血管阻力下降（47%）。第二组由15名患者组成，除常规治疗外还给予哌唑嗪。对哌唑嗪的效果进行临床监测。持续使用哌唑嗪治疗3周后，12名患者的临床状况改善至纽约心脏协会II级，而另外3名患者仅改善至纽约心脏协会III级。在进一步治疗期间，这种改善得以维持。治疗效果可根据临床特征轻松跟踪和评估，因此无需其他更复杂的随访方法。我们的研究结果表明，难治性心力衰竭患者可以安全地使用哌唑嗪，而无需事先评估血流动力学参数。
