Hydralazine in chronic CHF.

In summary, there investigations indicate that oral hydralazine produces beneficial hemodynamic effects in patients with chronic CHF. These favorable hemodynamic response are observed in the presence or absence of mechanical defects, such as mitral or aortic regurgitation. The predominant hemodynamic effects of hydralazine are substantial increase in CO and SV with decreased systemic vascular resistance. These investigations further suggest that hydralazine therapy not only improves resting cardiac performance, but also cardiac performance during exercise. There is also evidence that improved cardiac performance is sustained at least in some patients during maintenance hydralazine therapy. The impact of hydralazine therapy on the long term prognosis of patients with refractory CHF, however, remains unknown. Nevertheless, the preliminary retrospective studies suggest that in certain subsets of patients with severe chronic CHF, such therapy may provide a better prognosis compared to that expected with conventional therapy.