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March 1, 1982CirculationOpen Access

Effects of hydralazine on coronary blood flow and myocardial energetics in congestive heart failure.

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Why the study?

Does oral hydralazine improve coronary blood flow and myocardial energetics in patients with chronic nonischemic congestive heart failure?

Population

10 patients with chronic nonischemic congestive heart failure, mean age 48 years, 50% male. Key inclusion…

Comparison

Oral hydralazine 1 mg/kg single dose vs Baseline measurements

Design

Cohort

Follow-up

4 hours

Key result

Oral hydralazine acutely increased coronary blood flow from 144 to 218 ml/min and decreased coronary vascular resistance from 0.55 to 0.36 mm Hg/ml/min in nonischemic heart failure (p<0.01).

Authors

RMRaymond D. MagorienThe Ohio State UniversityGBGregory BrownUniversity of Nevada, Las VegasDUDonald V. UnverferthOhio State University Hospital

Discussion

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Overview

Hydralazine may augment coronary perfusion in nonischemic HF; leaves open whether this alters outcomes or energetics in RCTs.

Structured PICO

Does oral hydralazine improve coronary blood flow and myocardial energetics in patients with chronic nonischemic congestive heart failure?

P
Population
10 patients with chronic (New York Heart Association class III and IV) nonischemic congestive heart failure, mean age 48 years, 50% male. Key inclusion: LVEF < 35%.
I
Intervention
Oral hydralazine 1 mg/kg single dose
C
Comparator
Baseline measurements (4-hour control period prior to hydralazine administration)
O
Outcome
Coronary vascular resistance, coronary blood flow (estimated using coronary sinus thermodilution), and myocardial oxygen consumptionsurrogate

Main Result

Absolute Event Rate: 218% vs 144%

p-value: p=<0.01

In patients with severe nonischemic heart failure, acute administration of oral hydralazine significantly increases coronary blood flow and decreases coronary vascular resistance, improving the myocardial oxygen supply-demand ratio despite increased oxygen consumption.

Limitations

  • Small sample size

Cite This Study

Magorien et al. (1982) studied chronic nonischemic congestive heart failure (n=10). oral hydralazine vs. baseline was evaluated on coronary blood flow (p=<0.01). Oral hydralazine acutely increased coronary blood flow from 144 to 218 ml/min and decreased coronary vascular resistance from 0.55 to 0.36 mm Hg/ml/min in nonischemic heart failure (p<0.01).

synapsesocial.com/papers/6a051109fba2ba61ab55fa51https://doi.org/10.1161/01.cir.65.3.528
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