Hemodynamic effects of hydralazine in infants with idiopathic dilated cardiomyopathy and congestive heart failure

Michael Artman, Mark D Parrish, Scott Appleton, Robert J. Boucek, Thomas P. Graham

Research output: Contribution to journalArticle

4 Scopus citations

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 languageEnglish (US)
Pages (from-to)144-150
Number of pages7
JournalAmerican Heart Journal
Volume113
Issue number1
DOIs
StatePublished - 1987
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Hemodynamic effects of hydralazine in infants with idiopathic dilated cardiomyopathy and congestive heart failure'. Together they form a unique fingerprint.

  • Cite this