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

G. L. Pierpont, Jay N Cohn, J. A. Franciosa

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

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. The authors 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 < 0.001), and there were no differences between the two types of therapy. Both regimens reduced the right atrial pressure and dilated the veins of the forearm. Compared to administration of sodium nitroprusside, therapy with hydralazine alone lowered the pulmonary pressure less but raised the cardiac index as much; therapy with isosorbide dinitrate alone lowered pulmonary pressures as much as administration of sodium nitroprusside but raised the cardiac index less. Thus, by dilating both arteries and veins, combined oral therapy with hydralazine and isosorbide dinitrate closely mimics the hemodynamic effects of administration of sodium nitroprusside and may be useful for long term vasodilator therapy.

Original languageEnglish (US)
Pages (from-to)8-13
Number of pages6
JournalChest
Volume73
Issue number1
DOIs
StatePublished - Jan 1 1978

Fingerprint

Hydralazine
Nitroprusside
Nitrates
Hemodynamics
Isosorbide Dinitrate
Pulmonary Wedge Pressure
Therapeutics
Veins
Arterial Pressure
Pressure
Lung
Atrial Pressure
Vasodilator Agents
Cardiomyopathies
Forearm
Cardiac Output
Oral Administration
Heart Failure
Arteries

Cite this

Combined oral hydralazine-nitrate therapy in left ventricular failure. Hemodynamic equivalency to sodium nitroprusside. / Pierpont, G. L.; Cohn, Jay N; Franciosa, J. A.

In: Chest, Vol. 73, No. 1, 01.01.1978, p. 8-13.

Research output: Contribution to journalArticle

@article{66acfe166c444088965fc1d8a4e37af7,
title = "Combined oral hydralazine-nitrate therapy in left ventricular failure. Hemodynamic equivalency to sodium nitroprusside",
abstract = "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. The authors 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 < 0.001), and there were no differences between the two types of therapy. Both regimens reduced the right atrial pressure and dilated the veins of the forearm. Compared to administration of sodium nitroprusside, therapy with hydralazine alone lowered the pulmonary pressure less but raised the cardiac index as much; therapy with isosorbide dinitrate alone lowered pulmonary pressures as much as administration of sodium nitroprusside but raised the cardiac index less. Thus, by dilating both arteries and veins, combined oral therapy with hydralazine and isosorbide dinitrate closely mimics the hemodynamic effects of administration of sodium nitroprusside and may be useful for long term vasodilator therapy.",
author = "Pierpont, {G. L.} and Cohn, {Jay N} and Franciosa, {J. A.}",
year = "1978",
month = "1",
day = "1",
doi = "10.1378/chest.73.1.8",
language = "English (US)",
volume = "73",
pages = "8--13",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "1",

}

TY - JOUR

T1 - Combined oral hydralazine-nitrate therapy in left ventricular failure. Hemodynamic equivalency to sodium nitroprusside

AU - Pierpont, G. L.

AU - Cohn, Jay N

AU - Franciosa, J. A.

PY - 1978/1/1

Y1 - 1978/1/1

N2 - 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. The authors 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 < 0.001), and there were no differences between the two types of therapy. Both regimens reduced the right atrial pressure and dilated the veins of the forearm. Compared to administration of sodium nitroprusside, therapy with hydralazine alone lowered the pulmonary pressure less but raised the cardiac index as much; therapy with isosorbide dinitrate alone lowered pulmonary pressures as much as administration of sodium nitroprusside but raised the cardiac index less. Thus, by dilating both arteries and veins, combined oral therapy with hydralazine and isosorbide dinitrate closely mimics the hemodynamic effects of administration of sodium nitroprusside and may be useful for long term vasodilator therapy.

AB - 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. The authors 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 < 0.001), and there were no differences between the two types of therapy. Both regimens reduced the right atrial pressure and dilated the veins of the forearm. Compared to administration of sodium nitroprusside, therapy with hydralazine alone lowered the pulmonary pressure less but raised the cardiac index as much; therapy with isosorbide dinitrate alone lowered pulmonary pressures as much as administration of sodium nitroprusside but raised the cardiac index less. Thus, by dilating both arteries and veins, combined oral therapy with hydralazine and isosorbide dinitrate closely mimics the hemodynamic effects of administration of sodium nitroprusside and may be useful for long term vasodilator therapy.

UR - http://www.scopus.com/inward/record.url?scp=0017874011&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017874011&partnerID=8YFLogxK

U2 - 10.1378/chest.73.1.8

DO - 10.1378/chest.73.1.8

M3 - Article

C2 - 620563

AN - SCOPUS:0017874011

VL - 73

SP - 8

EP - 13

JO - Chest

JF - Chest

SN - 0012-3692

IS - 1

ER -