Hydralazine therapy in severe chronic heart failure: Inability of radionuclide left ventricular ejection fraction measurement to predict the hemodynamic response
| Autor: | Barry A. Franklin, Nicholas Z. Kerin, Mark J. Goldberg, Melvyn Rubenfire, Robert Ruskin, Harold J. Willens |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Haemodynamic response Heart Ventricles Rest Physical Exertion Cardiac index Hemodynamics Internal medicine medicine Humans Cardiac Output Radionuclide Imaging Aged Sodium Pertechnetate Tc 99m Heart Failure Ejection fraction business.industry Technetium Stroke Volume Stroke volume Middle Aged Hydralazine medicine.disease medicine.anatomical_structure Heart failure Chronic Disease Vascular resistance Cardiology Drug Evaluation Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. (5):887-893 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/S0735-1097(83)80236-8 |
| Popis: | Simultaneous hemodynamic and radionuclide angiographic assessment was made at rest and during exercise in nine patients with severe chronic congestive heart failure to determine the value of radionuclide left ventricular ejection fraction measurement in predicting the hemodynamic response to short-term treatment with oral hydralazine. Hydralazine, 50 to 100 mg orally every 6 hours, produced significant increases in cardiac index and stroke volume index at rest and during exercise (p < 0.01) and in left ventricular stroke work index at rest (p < 0.01) and during exercise (p < 0.05), significant decreases in systemic vascular resistance at rest and during exercise (p < 0.01) and significant increases in radionuclide angiographic left ventricular ejection fraction at rest (control 0.21 ± 0.06 vs. hydralazine 0.26 ± 0.07, p < 0.01) and during exercise (control 0.21 ± 0.08 vs. hydralazine 0.24 ± 0.09, p < 0.05). However, there were no statistically significant correlations between changes in radionuclide ejection fraction with hydralazine and changes in hemodynamic variables with hydralazine, either at rest or during exercise. Patients responding hemodynamically to hydralazine could not be separated from those not responding on the basis of the radionuclide ejection fraction at rest or changes in ejection fraction with hydralazine.It is concluded that: 1) hydralazine exerts beneficial effects on cardiac index, stroke volume index, left ventricular stroke work index and systemic vascular resistance both at rest and during exercise; 2) hydralazine therapy is associated with improvement in the radionuclide left ventricular ejection fraction both at rest and during exercise; but 3) the radionuclide ejection fraction response to hydralazine does not correlate with and cannot be used to predict the hemodynamic response to hydralazine in patients with severe chronic congestive heart failure. |
| Databáze: | OpenAIRE |
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