This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Gould, L. Articles by Abdou, O. Search for Related Content PubMed PubMed Citation Articles by Gould, L. Articles by Abdou, O. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Heart Failure Hazardous Substances DB PRAZOSIN HYDROCHLORIDE Social Bookmarking                         What's this?

Noninvasive Assessment of Left Ventricular Wall Stress in Chronic Congestive Heart Failure Patients

Department of Medicine, The Methodist Hospital, Brooklyn, NY

C. Gopalaswamy

Department of Medicine, The Methodist Hospital, Brooklyn, NY

F. Chandy

Department of Medicine, The Methodist Hospital, Brooklyn, NY

O. Abdou

Department of Medicine, The Methodist Hospital, Brooklyn, NY

In 1969, our group first reported that the intravenous administration of phentolamine can improve cardiac performance in patients with heart failure. ¹ Positive inotropism and a reduction in afterload were shown to be the mechanisms that led to cardiac improvement. Since that time the literature is replete with articles attesting to the benefits of vasodilator drugs in the treat ment of acute and chronic heart failure.

A reduction in impedance or afterload should produce beneficial hemodynamic effects in patients with left ventricular volume overload due to aortic insufficiency or mitral insufficiency. This has been verified using an intravenous infusion of nitroprusside, ^2,3 phentolamine⁴ and hydralazine.^5,6

The effects of vasodilators on left ventricular wall stress can now be evaluated noninvasively. Recently Wilson and his group⁷ documented that nitroglycerin can effectively reduce the peak and end systolic wall stress in patients with aortic regurgitation. These authors concluded that the beneficial action of nitroglycerin on muscle mechanics might retard left ventricular enlargement and hypertrophy and consequently delay the onset of myocardial dysfunction.

Prazosin is an oral drug with sustained vasodilator properties similar to nitroprusside which is widely used in the treatment of heart failure. This drug is a quinazoline derivative structurally unrelated to other vasodilator drugs pre sently available. It acts principally by blockade of vascular alpha-adrenergic receptors. It selectively blocks the postsynoptic or alpha 1 receptor while having little affinity for the pre-synoptic or alpha 2 receptor.

Angiology, Vol. 34, No. 2, 111-118 (1983)
DOI: 10.1177/000331978303400205


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?