[Comparative evaluation of the effectiveness of various peripheral vasodilators in the treatment of cardiac insufficiency].

The efficacy of peripheral vasodilators with different action mechanisms was studied and compared in 96 patients with chronic circulatory failure, stages IIB-III, of different genesis (rheumatic fever, congestive cardiomyopathy, postinfarction cardiosclerosis). Isosorbide dinitrate was used in 16 patients, nitroglycerin in 36, pratsiol in 24, and captopryl in 20 patients. Monitoring of the ECG, heart rate, respiratory rate and arterial blood pressure as well as catheterization of the right heart and tetrapolar impedance plethysmography were performed. The parameters of the heart pre- and afterload, pulmonary hemodynamics as well as those characterizing myocardial contractility were measured. It was established that the successful use of the different vasodilators rests on an adequate determinations of the indications for use. Captopryl is particularly effective in grave circulatory failure associated with a dramatic activation of the renin-angiotensin system. Pratsiol is effective in all the cases of chronic CF, since the tone of the sympathoadrenal system is virtually always high in patients with grave decompensation. Pratsiol was particularly efficacious in chronic CF with mitral or aortal regurgitation.