Acute and chronic cardiocirculatory effects of oral prazosin in chronic refractory heart failure

Japanese Heart Journal
H HayashiE Matsui

Abstract

The acute hemodynamic effects of oral prazosin were investigated in 7 patients with chronic refractory heart failure. A single dose of 1 to 3 mg prazosin produced a significant increase in cardiac index (+17.6%, p less than 0.01) associated with substantial decreases in pulmonary arterial diastolic pressure (-31.6%, p less than 0.02), systemic vascular resistance (-29.7%, p less than 0.01), and double product (-24.1%, p less than 0.02). Plasma renin activity was significantly elevated (+42.4%, p less than 0.02). These effects were found maximum at 2 hours and persisted for 8 hours. The chronic hemodynamic effects in 5 patients with chronic refractory heart failure were evaluated by administration of 1 to 2 mg prazosin 3 times daily for 8 weeks, and ventricular function was assessed by echocardiography and carotid pulse recording. All the patients showed improvement in the clinical symptoms of heart failure. Peripheral venous pressure decreased slightly (-12.5%). ET/PEP increased (+24.5%) without any significant changes in EF and mVcf. Plasma renin activity also slightly increased (+17.8%). Thus, prazosin possesses sustained nitroprusside-like actions, and is effective in the management of chronic congestive heart failure refrac...Continue Reading

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