Effect of orally administered hydralazine on neurohumoral factors and hemodynamic response in aged patients with chronic congestive heart failure.

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We studied the hemodynamic response to orally administered hydralazine (30mg) and examined the changes in neurohumoral factors in 16 aged patients with chronic congestive heart failure. After a single 30mg dose, 9 patients (Group I) demonstrated a greater than 30% decrease in systemic vascular resistance (SVR) and a significant increase in the cardiac index (CI); 7 patients, whose SVR was decreased by less than 30% (Group II), showed a less marked increase in CI. After 3 days of drug administration (90mg/day), the CI decreased in Group I (p<0.05) while it tended to increase further in Group II. Pretreatment plasma norepinephrine was lower in Group I than Group II (p<0.05). However, in Group I, it increased after 3 days of therapy, with a concomitant increase in plasma renin activity (p<0.01) and total plasma volume (p<0.025).We conclude that the higher pretreatment plasma norepinephrine level in Group II, suggestive of more severe derangement of left ventricular function, may be associated with a less pronounced dilatory response of the peripheral vasculature after a single dose of hydralazine, and that the increase in norepinephrine in Group I after 3 days of treatment may limit these patients' late hemodynamic responses to the drug.
International Heart Journal刊行会の論文