Document Detail


Vasodilator therapy in chronic congestive heart failure.
MedLine Citation:
PMID:  3291594     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Benefits from vasodilator therapy in patients with chronic heart failure are partly related to the severity of functional derangements. Agents with an arteriolar-dilating effect are more likely to be effective in patients with higher left ventricular outflow resistance. Vasodilators with primary venodilating properties are more likely to be effective in the presence of an increased ventricular preload. The mechanisms by which preload and left ventricular outflow resistance increase in patients with cardiac insufficiency are not well understood and may not be similar in all patients. Vasodilators also have the capacity to ameliorate myocardial metabolic functional abnormalities by influencing myocardial energetics, but the effects of different agents on coronary hemodynamics may not be uniform. Effects on renal hemodynamics may also vary, as may neurohumoral changes after therapy. Angiotensin-converting enzyme inhibitors have been shown to exert beneficial effects on both coronary and renal hemodynamics in patients with chronic heart failure, while producing favorable neurohumoral changes. These agents provide some advantages over direct-acting vasodilators in that myocardial oxygen consumption is decreased, myocardial metabolic function is improved, and norepinephrine and aldosterone levels are reduced. Further controlled studies are needed to assess the efficacy of angiotensin-converting enzyme inhibitors in relation to other vasodilators for the long-term management of these patients.
Authors:
K Chatterjee; T De Marco; J L Rouleau
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  62     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Jul 
Date Detail:
Created Date:  1988-08-05     Completed Date:  1988-08-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  46A-54A     Citation Subset:  AIM; IM    
Affiliation:
University of California, San Francisco 94143.
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathy, Dilated / drug therapy*
Chronic Disease
Hemodynamics / drug effects
Humans
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents

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


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