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Prazosin was administered orally at a maximal dose of 2 mg every 6 hours to 4 patients with congestive heart failure (CHF) who had not received either digitalis or diuretics for 72 hours before therapy. Three of the 4 patients had hypertensive and arteriosclerotic heart disease. Hemodynamic monitoring indicated a significant reduction of preload and afterload with a concomitant rise in the cardiac index. We concluded that isolated low-dose oral prazosin has salutary effects on indices of hemodynamic function in selected patients.

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Utilizing the apexcardiogram, the ratio of total amplitude to the height of the total diastolic wave was determined. Compared with a mean (+/- 1 SD) value of 21 +/- 4% for normal subjects there were statistically significant differences in those patients with isolated aortic regurgitation (30 +/- 10%, P = 0.01), aortic stenosis (12 +/- 11%, P less than 0.025) and mitral insufficiency (14 +/- 8%, P less than 0.025). There were no significant changes of this ratio in subjects with combined aortic stenosis and insufficiency (24 +/- 9%, P less than 0.25), triple vessel coronary artery disease (19 +/- 7%, P less than 0.25) and mitral valve prolapse (23 +/- 10%, P less than 0.35). There was a trend for higher ratio values in patients with greater angiographic evidence of aortic insufficiency, but no correlation between the ratio and left ventricular end-diastolic pressure. These alterations of the apexcardiogram accord with hemodynamic findings in the presence of each respective lesion. It is concluded that this ratio is useful for the noninvasive assessment of isolated aortic regurgitation, aortic stenosis and mitral insufficiency.

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