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Abstract

Objective: The aim of this study was to evaluate the efficacy and tolerability of small dose urapidil in the treatment of patients with severe congestive heart failure.Methods: Thirty patients with severe (NYHA class IV) congestive heart failure (male 16, female 14; mean age 55.3 ± 15.6 years) were randomly assigned to open-labeled treatment with urapidil (Group A, 15 patients) or nitroglycerin (Group B, 15 patients). Five patients had old myocardial infarction, 2 had essential hypertension, 22 idiopathic dilated cardiomyopathy, and one had peripartum cardiomyopathy. Both groups were comparable in respects of age, heart rate and blood pressure. Urapidil (100 μg/min) or nitroglycerin (20 μg/min) was administered intravenously for 24 hours in addition to conventional treatment of heart failure (oxygen, diuretic and digitalis). Heart rate, blood pressure, blood gas and echocardiography were measured before and after the treatment. Results: After treatment, relative changes of heart rate, diastolic blood pressure and blood gas compared with baseline were not significantly different in both groups. However, systolic blood pressure at 2 hours and 6 hours after treatment were lower in groups B (nitroglycerin) patients. In group A, the left ventricular systolic parameters and stroke volume measured by echocardiography increased significantly compared with baseline, and so were left ventricular ejection fraction and maximum flow velocity of aortic valve. In comparison, in group B, only left ventricular ejection fraction increased and flow accelerate time of E wave prolonged significantly. Conclusion: Small dose intravenous urapidil is a potentially useful agent in the management of severe congestive heart failure, demonstrating a significant improvement in cardiac systolic function and good tolerability.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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