Franciosa J A, Cohn J N
Circulation. 1981 Mar;63(3):652-7. doi: 10.1161/01.cir.63.3.652.
Vasodilators used in chronic congestive heart failure are not optimal in that nitrates are predominant venodilators, prazosin is associated with tolerance development, and hydralazine produces chronic toxicity. Therefore, we studied the acute hemodynamic effects of a single dose of minoxidil in 18 patients with chronic left ventricular failure caused by ischemic or primary cardiomyopathy. Peak effects were observed 5 hours after single oral doses of minoxidil, averaging 15.3 +/- 1.4 mg (SEM). Heart rate rose slightly, from 85.4 +/- 2.9 to 90.9 +/- 3.2 beats/min, after minoxidil (p less than 0.02) and mean arterial pressure fell slightly, from 88.0 +/- 2.3 to 84.9 +/- 2.5 mm Hg (p less than 0.05). Cardiac index increased from 2.34 +/- 0.l4 to 2.95 +/- 0.29 l/min/m2 after minoxidil (p less than 0.02) and systemic vascular resistance fell from 19.6 +/- 1.5 to 15.0 +/- 1.3 units (p less than 0.01). Minoxidil did not affect right atrial, pulmonary arterial and pulmonary wedge pressures. Hemodynamic effects of minoxidil persisted for at least 8 hours after a single dose. Minoxidil appears to be an effective arterial dilating agent in patients with heart failure and resembles hydralazine in its actions. Because of its potency, prolonged duration of action and relatively low toxicity, minoxidil may be a useful vasodilator for heart failure. However, its long-term effect must be further evaluated.
用于慢性充血性心力衰竭的血管扩张剂并非最佳选择，因为硝酸盐主要是静脉扩张剂，哌唑嗪会产生耐受性，而肼屈嗪会产生慢性毒性。因此，我们研究了单剂量米诺地尔对18例由缺血性或原发性心肌病引起的慢性左心室衰竭患者的急性血流动力学影响。单次口服米诺地尔平均剂量为15.3±1.4毫克（标准误）后5小时观察到峰值效应。服用米诺地尔后心率略有上升，从85.4±2.9次/分钟升至90.9±3.2次/分钟（p<0.02），平均动脉压略有下降，从88.0±2.3毫米汞柱降至84.9±2.5毫米汞柱（p<0.05）。服用米诺地尔后心脏指数从2.34±0.14升/分钟/平方米增至2.95±0.29升/分钟/平方米（p<0.02），全身血管阻力从19.6±1.5单位降至15.0±1.3单位（p<0.01）。米诺地尔对右心房、肺动脉和肺楔压无影响。单次给药后米诺地尔的血流动力学效应持续至少8小时。米诺地尔似乎是心力衰竭患者有效的动脉扩张剂，其作用类似于肼屈嗪。由于其效力、作用持续时间长且毒性相对较低，米诺地尔可能是一种用于心力衰竭的有用血管扩张剂。然而，其长期效果必须进一步评估。
