What question did this study set out to answer?

To evaluate the long-term effects of vasodilator therapy in patients with refractory heart failure and identify predictive hemodynamic variables.

September 1, 1981Circulation

Results of long-term vasodilator therapy in patients with refractory congestive heart failure.

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Why the study?

Does vasodilator therapy with hydralazine and nitrates improve survival and symptoms in patients with refractory congestive heart failure?

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.

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

Intervention

Oral hydralazine and long-acting nitrates

Outcome

Mortality and NYHA functional class at follow-uphard clinical

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Late response to vasodilators identifies refractory HF patients with superior survival; hypothesis-generating and should not yet change practice.

Walsh et al. (1981) studied this question.

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Late response to vasodilators identifies refractory HF patients with superior survival; hypothesis-generating and should not yet change practice.