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Previous Volume 303:250-255 July 31, 1980 Number 5 Next

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Abstract

To examine the importance of left ventricular chamber size in determing the response to vasodilator therapy, we performed echocardiography in 40 patients with chronic refractory heart failure before they were treated with oral hydralazine. The left ventricular end-diastolic dimension (LVEDD) correlated significantly with the per cent change in stroke volume (r = 0.77), left ventricular filling pressure (r = -0.68), and stroke work index (r = 0.87) during short-term drug administration. After 14 to 21 days of maintenance therapy, 15 of 24 patients with an LVEDD greater than or equal to 60 mm were improved, and one was worse; mean blood urea nitrogen decreased from 45.6 to 30.6 mg per deciliter in the 21 patients in this group who completed the study (16.3 to 10.9 mmol per liter) (P less than 0.001). In contrast, only two of 16 patients with an LVEDD less than 60 mm improved, whereas 10 showed clinical deterioration; blood urea nitrogen increased from 49.3 to 64.2 mg per deciliter in the 13 patients in this group who completed the study (17.6 to 22.9 mmol per liter) (P less than 0.01). These findings indicate that left ventricular chamber size is an important factor in the response to hydralazine in patients with severe chronic heart failure.

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• Packer, M. (1988). Clinical Trials in Congestive Heart Failure: Why Do Studies Report Conflicting Results?. ANN INTERN MED 109: 3-5 [Abstract]  
• PACKER, M., LEE, W. H., MEDINA, N., YUSHAK, M., KESSLER, P. D. (1987). Functional Renal Insufficiency During Long-Term Therapy with Captopril and Enalapril in Severe Chronic Heart Failure. ANN INTERN MED 106: 346-354 [Abstract]  
• Abrams, J. (1985). Vasodilator Therapy for Chronic Congestive Heart Failure. JAMA 254: 3070-3074 [Abstract]  
• PACKER, M., MEDINA, N., YUSHAK, M. (1984). Correction of Dilutional Hyponatremia in Severe Chronic Heart Failure by Converting-Enzyme Inhibition. ANN INTERN MED 100: 782-789 [Abstract]  
• Kronzon, I., Cohen, M., Winer, H. E. (1982). Adverse Effect of Hydralazine in Patients With Primary Pulmonary Hypertension. JAMA 247: 3112-3114 [Abstract]  
• Spodick, D. H. (1982). Effective Management of Congestive Cardiomyopathy: Relation to Ventricular Structure and Function. Arch Intern Med 142: 689-692 [Abstract]