Afterload reduction in congestive heart failure

In the clinical management of acute and chronic cardiac dysfunction, systemic vasodilators constitute a new approach through their reduction of elevated left ventricular wall tension during systole (ventricular afterload) by decreasing aortic impedance and/or diminishing venous return to the heart. Thus the agents may result in elevation of lowered cardiac output by reducing peripheral vascular resistance and/or in decline of increased ventricular end-diastolic volume (ventricular preload) by lowering venous tone. In addition, these agents cause concomitant reduction in myocardial oxygen requirements which is of special importance in ischemic heart disease.