Why the study?
Does the vasodilator regimen of hydralazine and isosorbide dinitrate reduce mortality in patients with chronic congestive heart failure?
Does the vasodilator regimen of hydralazine and isosorbide dinitrate reduce mortality in patients with chronic congestive heart failure?
The mortality benefit of hydralazine and isosorbide dinitrate in chronic heart failure is likely mediated by an increase in left ventricular ejection fraction rather than improved myocardial perfusion.
May support vasodilator use in chronic HF; leaves open causal mechanisms and needs prospective validation.
The reduction of mortality in patients with chronic congestive heart failure treated with the vasodilator regimen hydralazine and isosorbide dinitrate compared to those treated with placebo or prazosin in the Veterans Administration Cooperative Study (V-HeFT) was examined in order to explore the possible mechanism of the favourable effect. Similar efficacy in coronary and non-coronary disease patients tends to discount a prominent effect on myocardial perfusion. The most likely explanation for the prolonged survival on the effective vasodilator regimen is that these drugs tend to increase left ventricular ejection fraction, probably by a sustained effect on preload and impedance.
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Jay N. Cohn (1988) studied this question.
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