| Vasodilator therapy in chronic congestive heart failure. | |
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MedLine Citation:
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PMID: 3291594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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K Chatterjee; T De Marco; J L Rouleau |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The American journal of cardiology Volume: 62 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1988 Jul |
Date Detail:
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Created Date: 1988-08-05 Completed Date: 1988-08-05 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 46A-54A Citation Subset: AIM; IM |
Affiliation:
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University of California, San Francisco 94143. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiomyopathy, Dilated
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drug therapy* Chronic Disease Hemodynamics / drug effects Humans Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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