January 12, 1981
View Full PaperHydralazine in Chronic CHF
Key Result
Oral hydralazine produces beneficial hemodynamic effects in patients with chronic CHF by substantially increasing cardiac output and stroke volume while decreasing systemic vascular resistance.
Structured PICO
Does oral hydralazine improve hemodynamics and prognosis in patients with chronic congestive heart failure?
P
Population
Patients with chronic congestive heart failure (CHF), including those with or without mechanical defects such as mitral or aortic regurgitation, and refractory CHF.
I
Intervention
Oral hydralazine therapy
C
Comparator
Conventional therapy
O
Outcome
Hemodynamic effects (cardiac output, stroke volume, systemic vascular resistance) and cardiac performance at rest and during exercisesurrogate
Oral hydralazine improves hemodynamic parameters and cardiac performance in patients with chronic heart failure, though its definitive impact on long-term prognosis requires further study.
Limitations
- The impact of hydralazine therapy on the long term prognosis of patients with refractory CHF remains unknown.
Abstract
In summary, there investigations indicate that oral hydralazine produces beneficial hemodynamic effects in patients with chronic CHF. These favorable hemodynamic response are observed in the presence or absence of mechanical defects, such as mitral or aortic regurgitation. The predominant hemodynamic effects of hydralazine are substantial increase in CO and SV with decreased systemic vascular resistance. These investigations further suggest that hydralazine therapy not only improves resting cardiac performance, but also cardiac performance during exercise. There is also evidence that improved cardiac performance is sustained at least in some patients during maintenance hydralazine therapy. The impact of hydralazine therapy on the long term prognosis of patients with refractory CHF, however, remains unknown. Nevertheless, the preliminary retrospective studies suggest that in certain subsets of patients with severe chronic CHF, such therapy may provide a better prognosis compared to that expected with conventional therapy.