Prazosin in chronic congestive heart failure due to ischemic heart disease.

Oral prazosin hydrochloride (2-20 mg/day) was administered to 38 patients with chronic congestive heart failure due to ischemic heart disease for 6-18 months. Half (19) of the patients were hypertensive and half (19) nonhypertensive. All were receiving furosemide (80 mg/day, orally) and 19 were receiving digoxin (0.25-0.5 mg/day, orally) in addition to prazosin. Clinical radiological, mechanocardiographic, echocardiographic, and biochemical observations were made initially, at peak response, and at the end of 6 months. Prazosin improved left ventricular function indexes at rest, relieved symptoms and signs of congestion, and remained effective for 6-18 months with little or no increase in dose. There was no reflex tachycardia, tension-time indexes fell in all patients, angina was relieved in 8 patients who complained of it, and dyskinesia of left ventricular wall was corrected in 8 of 13 patients. The New York Heart Association functional class improved in all patients, but to a greater extent in hypertensive patients and in those not receiving concomitant digoxin. Mild, transient side effects occurred in 6 patients.

Effect of Abana on ventricular function in ischemic heart disease.

Mechanocardiography has been in use to evaluate ventricular function and the cardiac effect of drugs. Twenty-five patients with ischemic heart disease (IHD) and 25 patients with IHD and mild hypertension (HTN) were enrolled in a double-blind, placebo controlled study of Abana. Half the patients in each group received Abana--a formulation based on Ayurvedic principles--and the other half received a placebo in a randomized manner. The effect of Abana was evaluated by means of LV apex cardiogram (ACG), phonocardiogram and carotid pulse tracing and ECG (mechanocardiography) before and at the end of 8 weeks of treatment. As compared to placebo, Abana significantly reduced the frequency and severity of anginal episodes, as judged by clinical improvement and nitrate consumption. Significant improvement in ventricular function was observed as reflected by a decrease in ACG A amplitude and A wave duration, along with a significant increase in LV ejection fraction and VCF. The decrease in double and triple products reflected decreased MVO2. A significant fall in diastolic blood pressure was noted in patients with mild hypertension. Abana seems to reduce preload and afterload and improve diastolic function and pump function, which may be responsible for the beneficial effects of Abana in ischemic heart disease.