Document Detail

Does the magnitude of mitral regurgitation determine hemodynamic response to vasodilation in chronic congestive heart failure?
MedLine Citation:
PMID:  1935287     Owner:  NLM     Status:  MEDLINE    
Although it is usually assumed that direct-acting vasodilators improve cardiac function in patients with congestive heart failure (CHF) by altering left ventricular preload and afterload, several studies have suggested that most of the benefit occurs as a result of a reduction in associated mitral regurgitation (MR), which is present in the majority of patients with severe CHF. To test his hypothesis, the hemodynamic response to oral hydralazine was examined in CHF patients with competent mitral prostheses (group 1) and patients with CHF due to severe MR and left ventricular dysfunction (group 2). Both groups demonstrated significant increases in cardiac, stroke volume, and stroke work indices, although these were greater in group 2. Only group 2 experienced a significant reduction in left ventricular filling pressure. Thus, the presence of MR is not essential for hemodynamic improvement but is associated with significantly greater responses.
E A Haeusslein; B H Greenberg; B M Massie
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  100     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-03     Completed Date:  1991-12-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1312-5     Citation Subset:  AIM; IM    
Cardiovascular Research Institute, University of California, San Francisco.
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MeSH Terms
Chronic Disease
Heart Failure / drug therapy,  etiology,  physiopathology*
Heart Valve Prosthesis
Hemodynamics / drug effects*
Hydralazine / therapeutic use*
Middle Aged
Mitral Valve
Mitral Valve Insufficiency / complications,  physiopathology*
Retrospective Studies
Stroke Volume / physiology
Grant Support
Reg. No./Substance:

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