Abstract
We evaluated the acute hemodynamic responses to hydralazine during cardiac catheterization in 13 infants with idiopathic dilated cardiomyopathy. Ages ranged from 2 to 13 months (6.7 ± 4.0 months, mean ± SD). Each infant had congestive heart failure and angiographic evidence of markedly depressed left ventricular ejection fraction (0.24 ± 0.11; normal = 0.58 - 0.78) with left ventricular dilation (left ventricular end-diastolic volume = 349 ± 125% of normal). Hydralazine (0.5 to 1.0 mg/kg administered intravenously) acutely decreased systemic arteriolar resistance from 21.1 ± 3.3 to 12.0 ± 2.7 U/m2 (p < 0.001). This 41 ± 14% decrease in systemic resistance was accompanied by a 45 ± 16% increase in cardiac index (3.24 ± 0.53 to 4.71 ± 0.99 L/min/m2; p < 0.001). Mean arterial blood pressure declined from 70 ± 8 to 60 ± 11 mm Hg (p < 0.001). Hydralazine also increased heart rate (122 ± 19 to 138 ± 18 bpm; p < 0.001), but this increase did not account entirely for the change in cardiac index as evidenced by a rise in stroke volume index (26.9 ± 4.9 to 34.5 ± 7.5 ml/beat/m2; p < 0.001). Pulmonary arteriolar resistance and pulmonary capillary wedge pressure fell slightly in response to hydralazine. Subsequently, oral hydralazine was included in the treatment regimen of 10 infants followed for 3 to 38 months (mean = 15 months). Of these, eight demonstrated sustained clinical improvement. We conclude that hydralazine may be a beneficial adjunct to the management of congestive heart failure in young infants with a dilated cardiomyopathy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 144-150 |
| Number of pages | 7 |
| Journal | American Heart Journal |
| Volume | 113 |
| Issue number | 1 |
| DOIs | |
| State | Published - 1987 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Hemodynamic effects of hydralazine in infants with idiopathic dilated cardiomyopathy and congestive heart failure. / Artman, Michael; Parrish, Mark D; Appleton, Scott; Boucek, Robert J.; Graham, Thomas P.
In: American Heart Journal, Vol. 113, No. 1, 1987, p. 144-150.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hemodynamic effects of hydralazine in infants with idiopathic dilated cardiomyopathy and congestive heart failure
AU - Artman, Michael
AU - Parrish, Mark D
AU - Appleton, Scott
AU - Boucek, Robert J.
AU - Graham, Thomas P.
PY - 1987
Y1 - 1987
N2 - We evaluated the acute hemodynamic responses to hydralazine during cardiac catheterization in 13 infants with idiopathic dilated cardiomyopathy. Ages ranged from 2 to 13 months (6.7 ± 4.0 months, mean ± SD). Each infant had congestive heart failure and angiographic evidence of markedly depressed left ventricular ejection fraction (0.24 ± 0.11; normal = 0.58 - 0.78) with left ventricular dilation (left ventricular end-diastolic volume = 349 ± 125% of normal). Hydralazine (0.5 to 1.0 mg/kg administered intravenously) acutely decreased systemic arteriolar resistance from 21.1 ± 3.3 to 12.0 ± 2.7 U/m2 (p < 0.001). This 41 ± 14% decrease in systemic resistance was accompanied by a 45 ± 16% increase in cardiac index (3.24 ± 0.53 to 4.71 ± 0.99 L/min/m2; p < 0.001). Mean arterial blood pressure declined from 70 ± 8 to 60 ± 11 mm Hg (p < 0.001). Hydralazine also increased heart rate (122 ± 19 to 138 ± 18 bpm; p < 0.001), but this increase did not account entirely for the change in cardiac index as evidenced by a rise in stroke volume index (26.9 ± 4.9 to 34.5 ± 7.5 ml/beat/m2; p < 0.001). Pulmonary arteriolar resistance and pulmonary capillary wedge pressure fell slightly in response to hydralazine. Subsequently, oral hydralazine was included in the treatment regimen of 10 infants followed for 3 to 38 months (mean = 15 months). Of these, eight demonstrated sustained clinical improvement. We conclude that hydralazine may be a beneficial adjunct to the management of congestive heart failure in young infants with a dilated cardiomyopathy.
AB - We evaluated the acute hemodynamic responses to hydralazine during cardiac catheterization in 13 infants with idiopathic dilated cardiomyopathy. Ages ranged from 2 to 13 months (6.7 ± 4.0 months, mean ± SD). Each infant had congestive heart failure and angiographic evidence of markedly depressed left ventricular ejection fraction (0.24 ± 0.11; normal = 0.58 - 0.78) with left ventricular dilation (left ventricular end-diastolic volume = 349 ± 125% of normal). Hydralazine (0.5 to 1.0 mg/kg administered intravenously) acutely decreased systemic arteriolar resistance from 21.1 ± 3.3 to 12.0 ± 2.7 U/m2 (p < 0.001). This 41 ± 14% decrease in systemic resistance was accompanied by a 45 ± 16% increase in cardiac index (3.24 ± 0.53 to 4.71 ± 0.99 L/min/m2; p < 0.001). Mean arterial blood pressure declined from 70 ± 8 to 60 ± 11 mm Hg (p < 0.001). Hydralazine also increased heart rate (122 ± 19 to 138 ± 18 bpm; p < 0.001), but this increase did not account entirely for the change in cardiac index as evidenced by a rise in stroke volume index (26.9 ± 4.9 to 34.5 ± 7.5 ml/beat/m2; p < 0.001). Pulmonary arteriolar resistance and pulmonary capillary wedge pressure fell slightly in response to hydralazine. Subsequently, oral hydralazine was included in the treatment regimen of 10 infants followed for 3 to 38 months (mean = 15 months). Of these, eight demonstrated sustained clinical improvement. We conclude that hydralazine may be a beneficial adjunct to the management of congestive heart failure in young infants with a dilated cardiomyopathy.
UR - http://www.scopus.com/inward/record.url?scp=0023120766&partnerID=8YFLogxK
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U2 - 10.1016/0002-8703(87)90022-6
DO - 10.1016/0002-8703(87)90022-6
M3 - Article
VL - 113
SP - 144
EP - 150
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 1
ER -