重症心不全に対する新規Quinazoline系血管拡張剤，E−643（Bunazosin hydrochloride）の急性効果（第2報）—Ergometer運動負荷時の血行動態および代謝に及ぼす影響についての検討

Effects of oral bunazosin hydrochloride on hemodynainic and metabolic responses to exercise (Ergometer, 25W, 5min) in patients with severe congestive heart failure

　心不全に対する心室負荷軽減療法の1つとしてBuna—zosin hydrochloride （Bunazosinと略す）の急性効果の報告は数少なく^1〜3），運動負荷時の血行動態，代謝および交感神経系に及ぼす影響となるといまだ報告はない^8〜10）。

　以前より我々は重症心不全患者に対するBunazosinの急性効果として後負荷並びに前負荷軽減効果のみならず交感神経系およびガス分析面におげる改善も期待できることを報告してきた^1）。

Rest and exercise systemic hemodynamic and meta-bolic parameters were assessed before and 2 hrs after the oral administration of 2mg Bunazosin hydrochloride (E-643) in 6 patients with congestive heart failure.

When compared with control, E-643 increased rest and exercise cardiac index by 13% and 15% (p< 0.02), decreased rest and exercise pulmonary capillary wedge pressure by 33% and 39% (p<0.01), rest and exercise mean pulmonary arterial pressure by 35% and 37% (p<0.01). rest and exercise mean right atrial pressure by 56% and 45%) p<0.01), rest systemic vascular resistance index by 21% ) p<0.02), exercise double products by 9% (p<0.05), respectively whereas there was no significant change in rest and exercise heart rate, stroke volume index, renin activity, aldo-sterone, noradrenaline, adrenaline, lactate/pyruvate.

Therefore Bunazosin seemed to be a potent vasodi-lator with both acting as afterload and preload reduction and so to be useful for the treatment of severe heart failure as a deloading agent at rest and during exercise.