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Hemodynamic Improvement after Oral Hydralazine in Left Ventricular Failure: A Comparison with Nitroprusside Infusion in 16 Patients

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Grant support: in part by Research Grant HL18043-01 from the National Heart and Lung Institute.

Presented in part at the 33rd annual meeting of the American Federation for Clinical Research, Atlantic City, New Jersey, 2 May 1976.

▸Requests for reprints should be addressed to Joseph A. Franciosa, M.D.; Veterans Administration Hospital, 54th St. and 48th Ave. South; Minneapolis, MN 55417.

Minneapolis, Minnesota

Ann Intern Med. 1977;86(4):388-393. doi:10.7326/0003-4819-86-4-388
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Hydralazine was administered in a single oral dose of 50 to 100 mg in 16 patients with left ventricular failure due to cardiomyopathy. It produced sustained effects for at least 4 h characterized by a significant increase in cardiac output, a reduction in arterial and pulmonary arterial pressure, and a slight rise in heart rate. When compared to nitroprusside infusion in these same patients, hydralazine produced a similar reduction in systemic vascular resistance but a slightly greater increase in cardiac index (0.74 versus 0.95 litres/min · m2), with a lesser fall in mean arterial pressure (7.8 versus 13.6 mm Hg, P < 0.01), mean pulmonary arterial pressure (4.2 versus 11.3 mm Hg, P < 0.001), and pulmonary wedge pressure (5.5 versus 9.9 mm Hg, P < 0.001). Forearm venous tone decreased and venous compliance increased during nitroprusside infusion, but they were unchanged after hydralazine therapy. These data suggest that hydralazine may be a useful agent in the treatment of chronic left ventricular failure.





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