体循环血管收缩是充血性心力衰竭(CHF)的重要特征,主要表现为小动脉收缩、动脉顺应性降低和静脉容量缩减。作者采用脉动波分析技术表明,CHF患者远端肌性动脉顺应性总是大大降低,而近端弹性动脉顺应性有时略为降低。硝酸酯有效地提高动脉顺应性和扩大静脉容量,从而改善CHF患者血流动力状态。使用硝酸甘油或口服硝酸酯主要降低静脉张力和扩大静脉容量,使中心静脉压和肺楔压降低,减轻CHF症状。大剂量硝酸酯扩张冠状动脉和小动脉为时短暂。硝酸酯主要提高远端动脉(以及近端动脉)顺应性并使之弛张,而且维持时间较长;使每搏量和心排量增大,然而对CHF患者的作用较对健康者为弱。衰竭左室的Frank-Starling曲线较为平 Systolic vasoconstriction is an important characteristic of congestive heart failure (CHF) and is characterized by arteriolar constriction, reduced arterial compliance, and reduced venous volume. The authors used pulsatile wave analysis techniques to show that the compliance of distal muscular arteries in patients with CHF was always greatly reduced whereas the compliance of proximal arterial arteries was sometimes slightly reduced. Nitrates improve arterial compliance and expand venous volume, thereby improving hemodynamic status in CHF patients. The use of nitroglycerin or oral nitrates primarily reduces venous tension and enlarges venous capacity, lowering central venous pressure and pulmonary wedge pressure and alleviating CHF symptoms. Large doses of nitric oxide to dilate the coronary arteries and small arteries for a short time. Nitrates increase the compliance of distal arteries (and proximal arteries) and cause them to relax and maintain for a longer period of time, leading to an increase in stroke volume and cardiac output, whereas the effect on CHF patients is weaker than that of healthy subjects . Frank-Starling failure left ventricular curve is more flat