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Br Heart J. 1980 September; 44(3): 259–264.
PMCID: PMC482395

Haemodynamic effects of hydralazine at rest and during exercise in patients with chronic heart failure.

Abstract

The administration of vasodilator drugs has been shown to have beneficial effects at rest in patients with acute or chronic heart failure. To determine the efficacy of hydralazine during exercise, 10 severely symptomatic patients with chronic left ventricular failure from diffuse coronary disease or cardiomyopathy were studied at rest and during upright exercise on a bicycle ergometer. All patients were already receiving optimal treatment with digitalis and diuretics. At rest treatment with hydralazine resulted in a fall in both mean arterial and pulmonary wedge pressure. There was a 50 per cent reduction in systemic vascular resistance compared with pretreatment measurements and there was an equally impressive increase in stroke volume index. During exertion the changes noted at rest were sustained though occurred to a lesser degree; thus there was a 20 per cent fall in arterial resistance and a 20 per cent rise in stroke volume index compared with control. These findings show that hydralazine administration not only results in a beneficial effect on cardiac function at rest but that this effect is maintained during upright exercise in patients with impaired left ventricular function, thus providing further support for its use in the long-term management of such patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Franciosa JA, Limas CJ, Guiha NH, Rodriguera E, Cohn JN. Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet. 1972 Mar 25;1(7752):650–654. [PubMed]
  • Chatterjee K, Parmley WW, Ganz W, Forrester J, Walinsky P, Crexells C, Swan HJ. Hemodynamic and metabolic responses to vasodilator therapy in acute myocardial infarction. Circulation. 1973 Dec;48(6):1183–1193. [PubMed]
  • Chatterjee K, Parmley WW, Swan HJ, Berman G, Forrester J, Marcus HS. Beneficial effects of vasodilator agents in severe mitral regurgitation due to dysfunction of subvalvar apparatus. Circulation. 1973 Oct;48(4):684–690. [PubMed]
  • Guiha NH, Cohn JN, Mikulic E, Franciosa JA, Limas CJ. Treatment of refractory heart failure with infusion of nitroprusside. N Engl J Med. 1974 Sep 19;291(12):587–592. [PubMed]
  • Miller RR, Vismara LA, Zelis R, Amsterdam EA, Mason DT. Clinical use of sodium nitroprusside in chronic ischemic heart disease. Effects on peripheral vascular resistance and venous tone and on ventricular volume, pump and mechanical performance. Circulation. 1975 Feb;51(2):328–336. [PubMed]
  • Bolen JL, Alderman EL. Hemodynamic consequences of afterload reduction in patients with chronic aortic regurgitation. Circulation. 1976 May;53(5):879–883. [PubMed]
  • Mason DT, Braunwald E. The effects of nitroglycerin and amyl nitrite on arteriolar and venous tone in the human forearm. Circulation. 1965 Nov;32(5):755–766. [PubMed]
  • Miller RR, Vismara LA, Williams DO, Amsterdam EA, Mason DT. Pharmacological mechanisms for left ventricular unloading in clinical congestive heart failure. Differential effects of nitroprusside, phentolamine, and nitroglycerin on cardiac function and peripheral circulation. Circ Res. 1976 Jul;39(1):127–133. [PubMed]
  • Armstrong PW, Walker DC, Burton JR, Parker JO. Vasodilator therapy in acute myocardial infarction. A comparison of sodium nitroprusside and nitroglycerin. Circulation. 1975 Dec;52(6):1118–1122. [PubMed]
  • Williams DO, Amsterdam EA, Mason DT. Hemodynamic effects of nitroglycerin in acute myocardial infarction. Circulation. 1975 Mar;51(3):421–427. [PubMed]
  • FREIS ED, ROSE JC, HIGGINS TF, FINNERTY FA, Jr, KELLEY RT, PARTENOPE EA. The hemodynamic effects of hypotensive drugs in man. IV. 1-Hydrazinophthalazine. Circulation. 1953 Aug;8(2):199–204. [PubMed]
  • STUNKARD A, WERTHEIMER L, REDISCH W. Studies on hydralazine; evidence for a peripheral site of action. J Clin Invest. 1954 Jul;33(7):1047–1053. [PMC free article] [PubMed]
  • ROWE GG, HUSTON JH, MAXWELL GM, CROSLEY AP, Jr, CRUMPTON CW. Hemodynamic effects of 1-hydrazinophthalazine in patients with arterial hypertension. J Clin Invest. 1955 Jan;34(1):115–120. [PMC free article] [PubMed]
  • Chatterjee K, Parmley WW, Massie B, Greenberg B, Werner J, Klausner S, Norman A. Oral hydralazine therapy for chronic refractory heart failure. Circulation. 1976 Dec;54(6):879–883. [PubMed]
  • Franciosa JA, Pierpont G, Cohn JN. Hemodynamic improvement after oral hydralazine in left ventricular failure: a comparison with nitroprusside infusion in 16 patients. Ann Intern Med. 1977 Apr;86(4):388–393. [PubMed]
  • CHIDSEY CA, HARRISON DC, BRAUNWALD E. Augmentation of the plasma nor-epinephrine response to exercise in patients with congestive heart failure. N Engl J Med. 1962 Sep 27;267:650–654. [PubMed]
  • Zelis R, Mason DT, Braunwald E. A comparison of the effects of vasodilator stimuli on peripheral resistance vessels in normal subjects and in patients with congestive heart failure. J Clin Invest. 1968 Apr;47(4):960–970. [PMC free article] [PubMed]
  • Johnson BM. The use of radioactive microspheres to compare the effects of hydralazine, guanethidine and SK & F 24260 on the redistribution of cardiac output in anaesthetized rabbits. Br J Pharmacol. 1975 Nov;55(3):393–402. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group