September 1, 1981Circulation
Results of long-term vasodilator therapy in patients with refractory congestive heart failure.
Why the study?
Does vasodilator therapy with hydralazine and nitrates improve survival and symptoms in patients with refractory congestive heart failure?
Population
34 patients with refractory congestive heart failure
Design
Cohort
Follow-up
mean 8 to 10 months
Authors
Discussion
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Implication
Late response to vasodilators identifies refractory HF patients with superior survival; hypothesis-generating and should not yet change practice.
Key Points
- To evaluate the long-term effects of vasodilator therapy in patients with refractory heart failure and identify predictive hemodynamic variables.
- Studied 34 patients with refractory heart failure receiving oral hydralazine and long-acting nitrates.
- Patients were divided into responders and nonresponders based on clinical improvement.
- Follow-up duration averaged 10 months.
- Only 11% of late responders died vs 70% of late nonresponders (p<0.01).
- 1-year survival was 100% for late responders vs 13% for late nonresponders (p<0.01).
- Late responders had significantly lower mean right atrial and pulmonary artery wedge pressures.
Structured PICO
Does vasodilator therapy with hydralazine and nitrates improve survival and symptoms in patients with refractory congestive heart failure?
P
Population
34 patients with refractory congestive heart failure
I
Intervention
Oral hydralazine and long-acting nitrates
O
Outcome
Mortality and NYHA functional class at follow-uphard clinical
Cite This Study
Walsh et al. (1981) studied this question.