Efficacy of prazosin in the management of chronic congestive heart failure: a 6-month randomized, double-blind, placebo-controlled study.
Efficacy of prazosin in the management of chronic congestive heart failure: a 6-month randomized, double-blind, placebo-controlled study.
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哌唑嗪治疗慢性充血性心力衰竭的疗效：一项为期 6 个月的随机、双盲、安慰剂对照研究。
DOI：
10.1016/0002-9149(83)90310-7
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
Firth,BG
中科院分区：
文献类型：
--
作者：
MarkhamJr,RV;Corbett,JR;Gilmore,A;Pettinger,WA;Firth,BG
急性哌唑嗪治疗对充血性心力衰竭（CHF）患者的有益效果已得到充分证明；然而，其几个月的长期疗效此前并未以安慰剂对照的方式进行过评估。因此，通过放射性核素心室造影评估哌唑嗪 20 mg/天对静息时和直立自行车运动峰值时左心室射血分数、收缩末期和舒张末期容积的影响，以及对静息时右心室射血分数、运动时间和工作负荷的影响，以及 23 名具有稳定 CHF III 症状的患者的标准临床变量。该研究对接受稳定剂量洋地黄和利尿剂至少 1 个月的患者进行了为期 6 个月的随机、双盲、对照评估，对比哌唑嗪与安慰剂。入组时，哌唑嗪组和安慰剂组在任何方面都没有差异。与安慰剂相比，哌唑嗪对症状状态、心率、平均动脉压和心胸比等临床变量没有明显影响。与安慰剂相比，哌唑嗪对静息或运动高峰时放射性核素变量的绝对或百分比变化、或对运动时间或运动负荷没有产生明显的影响。此外，与安慰剂相比，哌唑嗪对血浆肾素活性或血浆儿茶酚胺水平没有一致的影响。然而，随着时间的推移，两组的体重（p < 0.0001）和直立位血浆肾素活性（p < 0.002）都有轻微但显着的增加，并且利尿剂剂量有随时间增加的趋势。因此，长期哌唑嗪治疗通常不会对接受洋地黄和利尿治疗的稳定慢性 III 类 CHF 患者产生明显的主观或客观改善。
The beneficial effects of acute prazosin therapy in patients with congestive heart failure (CHF) have been well documented; however, its chronic efficacy over several months has not previously been evaluated in a placebo-controlled manner. Therefore, an assessment was made by radionuclide ventriculography of the effect of prazosin, 20 mg/day, on left ventricular ejection fraction and end-systolic and end-diastolic volumes at rest and on peak upright bicycle exercise, as well as its effect on right ventricular ejection fraction at rest, exercise time and work load, and standard clinical variables in 23 patients with stable class III symptoms of CHF. The study consisted of a 6-month randomized, doubleblind, controlled evaluation of prazosin versus placebo in patients receiving a stable dose of digitalis and diuretics for at least 1 month. At entry, the prazosin and placebo groups did not differ in any respect. Prazosin caused no demonstrable effect on clinical variables such as status of symptoms, heart rate, mean arterial pressure, and cardiothoracic ratio when compared with placebo. Prazosin also caused no demonstrable effect compared with placebo on absolute or percent changes in radionuclide variables at rest or on peak exercise, or on exercise time or exercise work load. In addition, prazosin had no consistent effect compared with placebo on plasma renin activity or plasma catecholamine levels. However, there was a slight but significant increase in weight (p < 0.0001) and in plasma renin activity in the upright position (p < 0.002) with time, as well as a tendency for the diuretic dose to increase with time in both groups. Thus, long-term prazosin therapy generally produces no demonstrable subjective or objective improvement in patients with stable, chronic class III CHF receiving digitalis and diuretic therapy.