Impedance reduction in severe left ventricular failure

N. A. Awan, Ezra A Amsterdam, D. T. Mason

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Although digitalis and diuretics constitute the traditional therapy for congestive heart failure, the systemic vasodilators offer an innovative approach in both acute and chronic heart failure. By decreasing increased left venrticular systolic wall tension (ventricular afterload) through a reduction in aortic impedance, vasodilators increase the cardiac output and decrease an elevated left ventricular end-diastolic pressure (ventricular preload) tone. diminishing venous tobe. Concomitantly, myocardial oxygen demand is reduced, in turn reducing myocardial ischemia in coronary artery disease and potentially limiting infarct size, provided systemic arterial pressure remains normal in patients with infarction. However, the various vasodilators produce disparate changes in cardiac function depending upon their differing actions on preload versus impedance. A thorough understanding of the pharmacology and interactions of these agents, as well as of the physiologic determinants of cardiac function, is crucial to proper selection and use of these drugs for impedance reduction in left ventricular failure.

Original languageEnglish (US)
Pages (from-to)933-957
Number of pages25
JournalCardiovascular Medicine
Issue number9
StatePublished - 1979

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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