慢性うっ血性心不全に対するBunazosin，Captoprilの効果発現の差異に関する検討—血行動態諸量と神経体液性因子を指標として

The effect of Bunazosin vs Captopril on hemodynamic and neurohumoral parameters in patients with congestive heart failure

　近年，慢性うっ血性心不全に対する血管拡張薬の有用性が広く認識され^1〜3），とりわけAngiotensin変換酵素阻害薬（ACEI）とα₁遮断薬の効果に関心が注がれている。

　そこで著者らは慢性うっ血性心不全例を対象にBuna-zosin （α₁遮断薬）とCaptopril （ACEI）の急性および慢性効果発現の差異を，血行動態諸量と神経体液性因子を指標として検討したので報告する。

The hemodynamic parameters (right atrial pres-sure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index, heart rate, blood pressure) and neurohumoral responces (α-ANP, plasma renin activity, aldosterone, angiotensin II) of Captopril, oral ACE inhibitor, and Bunazosin, oral α-blocker, were investigated in 28 patients with congestive heart failure at rest and after ex-ercise. These data were analysed in both acute and chronic phases.

1) Acute effect. Captopril produced significant improvement of neurohumoral factors at rest and also after exercise. Bunazosin reduced α-ANP, but other neurohumoral factors did not change. Buna-zosin produced significant hemodynamic improve-ment both at rest and after exercise. 2) Chronic ef-fect. Captopril produced significant hemodynamic improvement both at rest and after exercise. Impro-vement of neurohumoral factors in acute phase was also preserved at chronic phase. On Bunazosin, improvement of hemodynamics at acute phase was also preserved at chronic phase without deteriora-tion of neurohumoral factors.