Lopez-Sendon J, Coma-Canella I, Lombera F, Jadraque L M
Am Heart J. 1979 Oct;98(4):495-504.
The hemodynamic effects of the new oral vasocilator prazosin were evaluated in 11 patients with congestive failure following myocardial infarction. Prazosin decreased pulmonary trunk, pulmonary capillary, and right atrial pressures, systemic blood pressure, systemic vascular and total pulmonary resistances, and the heart rate X systolic blood pressure product (P less than 0.001). Cardiac and stroke indexes increased (P less than 0.001 and P less than 0.02, respectively). Heart rate, myocardial perfusion gradient, and stroke work index remained unchanged (P less than 0.05). Prazosin effect began in most patients 30 minutes after an oral administration of 2.5 to 7 mg; the maximum effect occurred from one to three hours later. The action is sustained for at least 6 hours in most patients and sometimes is present even 12 hours after a single dose administration. We conclude that prazosin, with a nitroprusside-like effect, improves left ventricular performance and myocardial O2 supply-demand relationship in patients with acute myocardial infarction, but optimal doses vary significantly, and the hazard of severe and sustained hypotension, or decline in cardiac output in patients with normal blood pressure or slightly elevated filling pressure, is present.
对11例心肌梗死后充血性心力衰竭患者评估了新型口服血管扩张剂哌唑嗪的血流动力学效应。哌唑嗪降低了肺动脉干、肺毛细血管和右心房压力、体循环血压、体循环血管阻力和总肺阻力以及心率与收缩压的乘积（P<0.001）。心指数和每搏指数增加（分别为P<0.001和P<0.02）。心率、心肌灌注梯度和每搏作功指数保持不变（P>0.05）。多数患者口服2.5至7毫克哌唑嗪30分钟后开始出现效应；最大效应在1至3小时后出现。多数患者中该作用至少持续6小时，单次给药后有时甚至12小时仍有作用。我们得出结论，哌唑嗪具有类似硝普钠的效应，可改善急性心肌梗死患者的左心室功能及心肌氧供需关系，但最佳剂量差异显著，且存在严重且持续性低血压的风险，或血压正常或充盈压轻度升高患者的心输出量下降。
