Circulation, Vol 62, 49-55, Copyright © 1980 by American Heart Association
BH Greenberg, H DeMots, E Murphy and S Rahimtoola
We studied the effects of afterload reduction in chronic severe aortic
insufficiency by measuring the hemodynamic response to oral hydralazine in
10 consecutive patients. Hemodynamics were also measured during maximal
exercise in eight of these patients. At rest, hydralazine reduced pulmonary
artery wedge pressure from 14 to 9 mm Hg (p less than 0.01), and increased
cardiac index by 70% and stroke volume index by 35% (both p less than
0.001). Before hydralazine, pulmonary artery wedge pressure exceeded 20 mm
Hg in five patients during maximal exercise; with hydralazine, at identical
levels of exercise, pulmonary artery wedge pressure remained below 20 mm Hg
in all patients. For the group, hydralazine reduced pulmonary artery wedge
pressure from 21 to 12 mm Hg (p less than 0.05) and increased cardiac index
by 31% (p less than 0.05) during exercise; changes in stroke volume index
were more variable and there was no significant increase for the group,
although several patients increased stroke volume substantially and the
overall increase was 34%. These data show that afterload reduction has
beneficial effects on cardiac performance in chronic severe aortic
insufficiency both at rest and during exercise. Hydralazine may be of use
in such patients either in preparation for valve replacement or as interim
therapy.
ARTICLES
Beneficial effects of hydralazine on rest and exercise hemodynamics in patients with chronic severe aortic insufficiency
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