Parmley W W, Rouleau J L, Chatterjee K
Am Heart J. 1982 Apr;103(4 Pt 2):625-32. doi: 10.1016/0002-8703(82)90467-7.
Although vasodilators produce acute beneficial hemodynamic effects in patients with chronic congestive heart failure, their effects on the long-term management of such patients are unclear. In 56 patients followed up for an average of 13 months, there was a 37% mortality at 1 year. Because of the potential adverse effects of vasodilators in patients with coronary artery disease, we evaluated the effects of prazosin, hydralazine, and isosorbide dinitrate on hemodynamics, coronary sinus flow, and myocardial oxygen consumption (MVO2). Isosorbide dinitrate reduced ventricular filling pressure with no change in heart rate or mean arterial pressure; coronary sinus flow and MVO2 fell significantly. With prazosin there was a reduction in ventricular filling pressures and rate-pressure product but no change in coronary sinus flow or MVO2. With hydralazine there were parallel changes in the rate-pressure product and MVO2. Results emphasize the differing effects of vasodilators on oxygen supply and demand, which may influence the long-term course of patients with coronary artery disease.
尽管血管扩张剂对慢性充血性心力衰竭患者可产生急性有益的血流动力学效应，但其对此类患者的长期治疗效果尚不清楚。在平均随访13个月的56例患者中，1年时的死亡率为37%。由于血管扩张剂对冠心病患者存在潜在不良反应，我们评估了哌唑嗪、肼屈嗪和硝酸异山梨酯对血流动力学、冠状窦血流及心肌耗氧量（MVO2）的影响。硝酸异山梨酯降低了心室充盈压，心率和平均动脉压无变化；冠状窦血流和MVO2显著下降。使用哌唑嗪时，心室充盈压和心率-血压乘积降低，但冠状窦血流或MVO2无变化。使用肼屈嗪时，心率-血压乘积和MVO2发生平行变化。结果强调了血管扩张剂对氧供和氧需的不同影响，这可能会影响冠心病患者的长期病程。
