Document Detail


Hemodynamic responses to combined therapy with captopril and hydralazine in patients with severe heart failure.
MedLine Citation:
PMID:  6345633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hemodynamic benefits and safety of combined therapy with captopril and hydralazine were studied during invasive hemodynamic monitoring in 14 patients with severe heart failure. In eight patients, the individual effects of both drugs were evaluated before the administration of combined therapy, whereas hydralazine was added to maintenance captopril therapy in the other six patients. In the first group, captopril alone produced a marked decrease in pulmonary wedge pressure (28 +/- 4 to 18 +/- 5 mm Hg) and mean arterial pressure (85 +/- 20 to 69 +/- 13 mm Hg) (both p less than 0.001) without a significant increase in cardiac index. Hydralazine alone produced a marked increase in cardiac index (1.6 +/- 0.4 to 2.7 +/- 0.5 liters/min per m2) (p less than 0.001), but with a minimal decrease in pulmonary wedge pressure (28 +/- 4 to 23 +/- 4 mm Hg) (p less than 0.05) and without a significant change in mean arterial pressure. The combination of captopril and hydralazine produced an increase in cardiac index similar to that of hydralazine alone and decreases in pulmonary wedge pressure and mean arterial pressure similar to those with captopril alone. Most important, when hydralazine was added to captopril in the entire group of 14 patients, cardiac index increased markedly with little additional decrease in mean arterial pressure and no significant increase in heart rate. The one patient who experienced symptomatic hypotension with combination therapy also had dizziness with captopril alone. Seven of the nine patients maintained on long-term treatment experienced symptomatic improvement. Thus, in patients with severe chronic heart failure, the combined use of captopril and hydralazine is feasible and produces acute hemodynamic improvement superior to that from either drug alone.
Authors:
B M Massie; M Packer; J T Hanlon; D T Combs
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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:  Journal of the American College of Cardiology     Volume:  2     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1983 Aug 
Date Detail:
Created Date:  1983-08-26     Completed Date:  1983-08-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  338-44     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / drug effects
Captopril / administration & dosage*,  adverse effects
Cardiac Output / drug effects
Drug Therapy, Combination
Female
Heart Failure / drug therapy*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Hydralazine / administration & dosage*
Hypotension / chemically induced
Male
Middle Aged
Proline / analogs & derivatives*
Pulmonary Wedge Pressure / drug effects
Risk
Time Factors
Grant Support
ID/Acronym/Agency:
HL 28146/HL/NHLBI NIH HHS; R23-HL 25055/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
147-85-3/Proline; 62571-86-2/Captopril; 86-54-4/Hydralazine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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