Long-Term Vasodilator Therapy in Aortic Insufficiency

Although the beneficial effects of acute therapy with arteriolar dilators in aortic insufficiency have been shown, the results of long-term therapy are uncertain. The administration of oral hydralazine, 125 mg twice a day, to a 54-year-old woman with chronic severe aortic insufficiency resulted in sustained relief of heart failure symptoms. Repeat catheterization after 14 months showed hemodynamic improvement, substantial reduction in left ventricular chamber size and muscle mass, and recovery of systolic pump function. Chronic therapy with arteriolar dilators may be a useful alternative to valve replacement in selected patients with aortic insufficiency.