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硝酸甘油是第一种在左室衰竭病人中致使血流动力学改善的血管扩张药,其衍化物长效的二硝基异山梨醇(ISDN)为广泛用于治疗这些危重病人的第一种药物。过去十年中,硝酸酯类在心力衰竭病人中的短期和长期血流动力学效果已经广泛研究,其临床效益至少已在二项各别进行的双盲、安慰剂对照试验中证实。再则,硝酸酯疗法耐受良好,在心力衰竭病人中头痛、脸红和头晕的发生率比在心绞痛病人中为少,因而心力衰竭病人很少因不良反应而停用硝酸酯类。已知上述长处之后,有机硝酸酯类在处理严重心力衰竭病人中的可能效益最近尚未
Nitroglycerin is the first vasodilator to result in improved hemodynamics in patients with left ventricular failure and its long-acting dinitroisosorbide (ISDN) derivative is the first of its kind widely used to treat these critically ill patients drug. The short-term and long-term hemodynamic effects of nitrates in heart failure patients have been extensively studied over the past decade and the clinical benefits have been demonstrated in at least two separate, double-blind, placebo-controlled trials. In addition, nitrates therapy is well tolerated, with fewer headaches, blushing and dizziness in patients with heart failure than in patients with angina, so patients with heart failure are less likely to discontinue nitrates because of adverse reactions. Given the above benefits, the potential benefits of organic nitrates in treating patients with severe heart failure have not been seen recently