Acute Hemodynamic and Long‐Term Clinical Effects of Prazosin in the Treatment of Chronic Congestive Heart Failure

Abstract

ABSTRACT. The effect of prazosin in congestive heart failure was assessed in 10 patients (age 39–69 years) with ischemic heart disease or cardiomyopathy in functional class II‐IV (NYHA). All patients were treated with digitalis and diuretics in optimal doses. Mean (± S.E.M.) cardiac index (CI) was 2.2±0.2 l/min/m2 before and 2.3±0.1 one hour after oral administration of 2–4 mg prazosin (given as tablets) (p>0.10). Mean pulmonary capillary wedge pressure (PWP) fell from 24±4 to 20±4 mmHg (p>0.10). Prazosin seemed to have a more beneficial effect on patients with markedly elevated PWP or reduced CI before prazosin administration. The effect of prazosin on heart rate and systolic blood pressure was insignificant. During a follow‐up period of 1–20 months (mean 7.3), 2 of 7 patients treated with prazosin (2–4 mg daily) improved their clinical condition, one patient was unchanged and 4 patients died in progressive cardiac failure. The results indicate that some patients with severe heart failure may benefit from prazosin when conventional treatment has failed.