Influence of oral prazosin therapy on exercise hemodynamics in patients with severe chronic heart failure

In 10 patients with severe chronic congestive heart failure, changes in hemodynamic and cardiac performance at rest and during exercise were evaluated following short-term oral prazosin therapy. The median total dose of prazosin was 43 mg (range 23 to 95 mg) and the median duration of therapy was 47 hours (range 18 to 92 hours). Prazosin increased cardiac output and stroke volume significantly during exercise (both p less than 0.05) but not at rest (both p greater than 0.10). The magnitude of the increase in pulmonary capillary wedge pressure during exercise with the addition of prazosin was also significantly less than that during conventional therapy, suggesting improved cardiac performance during exercise. Peak oxygen consumption, peak lactate concentration and rate of disappearance of the increased concentration of lactate induced by exercise, however, remained unchanged following prazosin therapy. These findings suggest that short-term prazosin therapy, as other vasodilators, improves cardiac performance during exercise but may not necessarily influence oxygen consumption.