Laslett L J, DeMaria A N, Amsterdam E A, Mason D T
Arch Intern Med. 1978 May;138(5):819-20.
Severe tachycardia, ventricular ectopy, and sodium retention manifested by hemodynamic deterioration developed with hydralazine hydrochloride therapy in chronic coronary heart disease with congestive failure refractory to digitalis, diuretics, and nitrates. Coronary care unit admission with Swan-Ganz catheterization corrected hemodynamics by sodium nitroprusside treatment after hydralazine withdrawal. Satisfactory cardiac performance with oral long-acting nitrates were unsuccessful. However, the new oral vasocilator, prazosin hydrochloride, achieved considerable hemodynamic benefit by greatly reducing elevated left ventricular filling pressure and increasing severely depressed cardiac index to normal, accompanied by striking symptomatic improvement. Furthermore, long-term enhancement of cardiac dynamics and salutary functional status was maintained by ambulatory oral prazosin therapy for several months. This experience demonstrates the favorable alternative of prazosin nitroprusside-like actions over hydralazine-nitrate therapy in heart failure therapy and emphasizes prazosin's utility when untoward side effects to hydralazine develop.
在患有充血性心力衰竭且对洋地黄、利尿剂和硝酸盐治疗无效的慢性冠心病患者中，使用盐酸肼屈嗪治疗时出现了严重心动过速、室性异位心律以及以血流动力学恶化为表现的钠潴留。在停用肼屈嗪后，通过硝普钠治疗，经 Swan-Ganz 导管插入术进入冠心病监护病房纠正了血流动力学。口服长效硝酸盐未能使心脏功能达到满意状态。然而，新型口服血管扩张剂盐酸哌唑嗪通过大幅降低升高的左心室充盈压并将严重降低的心脏指数提高至正常水平，实现了显著的血流动力学益处，同时症状也有明显改善。此外，通过门诊口服哌唑嗪治疗数月，维持了心脏动力学的长期改善和有益的功能状态。这一经验表明，在心力衰竭治疗中，哌唑嗪具有类似硝普钠的作用，是优于肼屈嗪 - 硝酸盐治疗的有利选择，并强调了在出现肼屈嗪不良副作用时哌唑嗪的效用。
