Combined oral hydralazine-nitrate therapy in left ventricular failure. Hemodynamic equivalency to sodium nitroprusside.

Administration of sodium nitroprusside increases the cardiac output and decreases the pulmonary wedge pressure in patients with left ventricular failure. Drugs suitable for long-term oral administration have not been as effective as intravenous therapy with sodium nitroprusside. We compared the hemodynamic effects of combined oral therapy with hydralazine and isosorbide dinitrate (100 mg of hydralazine plus 10 to 50 mg of chewable isosorbide dinitrate) to the effects of intravenous therapy with sodium nitroprusside in 15 patients with congestive heart failure (class 3 to 4) due to cardiomyopathy. Therapy with sodium nitroprusside reduced the mean arterial pressure by 11.3 mm Hg and the pulmonary wedge pressure by 10.4 mm Hg while increasing the cardiac index by 0.72 L/min/sq m. The combined oral therapy also reduced the mean arterial pressure by 12.0 mm Hg and the pulmonary wedge pressure by 12.0 mm Hg while increasing the cardiac index by 0.81 L/min/sq m in the same patients. All changes were significant (P

[1]  J. Cohn,et al.  Nitrate effects on cardiac output and left ventricular outflow resistance in chronic congestive heart failure. , 1978, The American journal of medicine.

[2]  J. Cohn,et al.  Hemodynamic improvement after oral hydralazine in left ventricular failure: a comparison with nitroprusside infusion in 16 patients. , 1977, Annals of internal medicine.

[3]  B. Massie,et al.  Oral Hydralazine Therapy for Chronic Refractory Heart Failure , 1976, Circulation.

[4]  W. Parmley,et al.  Combination vasodilator therapy for severe chronic congestive heart failure. , 1976, Annals of internal medicine.

[5]  R. Miller,et al.  Pharmacological Mechanisms for Left Ventricular Unloading in Clinical Congestive Heart Failure: Differential Effects of Nitropmsside, Phentolamine, and Nitroglycerin on Cardiac Function and Peripheral Circulation , 1976, Circulation research.

[6]  E. Alderman,et al.  Hemodynamic Consequences of Afterload Reduction in Patients with Chronic Aortic Regurgitation , 1976, Circulation.

[7]  J. Cohn,et al.  Hemodynamic improvement with hydralazine in left heart failure , 1976 .

[8]  K. O’malley,et al.  Duration of hydralazine action in hypertension , 1975, Clinical pharmacology and therapeutics.

[9]  J. Cohn,et al.  Comparative Hemodynamic Effects of Chewable Isosorbide Dinitrate and Nitroglycerin in Patients with Congestive Heart Failure , 1975, Circulation.

[10]  R R Miller,et al.  Clinical Use of Sodium Nitroprusside in Chronic Ischemic Heart Disease: Effects on Peripheral Vascular Resistance and Venous Tone and on Ventricular Volume, Pump and Mechanical Performance , 1975, Circulation.

[11]  Kyuhyun Wang,et al.  Hemodynamic Predictors of Myocardial Oxygen Consumption During Static and Dynamic Exercise , 1974, Circulation.

[12]  J. Cohn,et al.  Treatment of refractory heart failure with infusion of nitroprusside. , 1974, The New England journal of medicine.

[13]  S. Shulman,et al.  Letter: Transfer-factor therapy of chronic active hepatitis. , 1974, Lancet.

[14]  W. Parmley,et al.  Hemodynamic and Metabolic Responses to Vasodilator Therapy in Acute Myocardial Infarction , 1973, Circulation.

[15]  W. Parmley,et al.  Beneficial Effects of Vasodilator Agents in Severe Mitral Regurgitation Due to Dysfunction of Subvalvar Apparatus , 1973, Circulation.

[16]  H. Perry.  Late toxicity to hydralazine resembling systemic lupus erythematosus or rheumatoid arthritis. , 1973, The American journal of medicine.

[17]  J. Cohn,et al.  IMPROVED LEFT VENTRICULAR FUNCTION DURING NITROPRUSSIDE INFUSION IN ACUTE MYOCARDIAL INFARCTION , 1972 .

[18]  G. Diamond,et al.  Thermodilution cardiac output determination with a single flow-directed catheter. , 1972, American heart journal.

[19]  G. Gensini,et al.  Quantitative angiography: the measurement of coronary vasomobility in the intact animal and man. , 1971, Chest.

[20]  G. Diamond,et al.  Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. , 1970, The New England journal of medicine.

[21]  D. Moore-Jones,et al.  Radioautographic Localization of Hydralazine-1-C14 in Arterial Walls.∗ , 1966, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[22]  J. Cohn.  Relationship of plasma volume changes to resistance and capacitance vessel effects of sympathomimetic amines and angiotensin in man. , 1966, Clinical science.

[23]  E. Braunwald,et al.  The Effects of Nitroglycerin and Amyl Nitrite on Arteriolar and Venous Tone in the Human Forearm , 1965, Circulation.

[24]  W. Hollander,et al.  The Effects of Intravenous Apresoline (Hydralazine) on Cardiovascular and Renal Function in Patients with and without Congestive Heart Failure , 1956, Circulation.

[25]  G. Rowe,et al.  The effects of 1-hydrazinophthalazine upon coronary hemodynamics and myocardial oxygen metabolism in essential hypertension. , 1955, The Journal of clinical investigation.