[Long-term use of vasodilators in patients with congestive cardiomyopathy (author's transl)].
Three patients with congestive cardiomyopathy were studied for the acute and chronic hemodynamic effects of vasodilators using right heart catheterization, echocardiography and exercise tolerance test. All of the three were in congestive heart failure and were on digoxin and furosemide. Various vasodilators were used, which included isosorbide dinitrate, hydralazine, phentolamine and prazosin. Favorable acute hemodynamic effects were seen in all three. However, on continued use, all three showed evidence of tolerance to vasodilators by hemodynamic measurements. The first patient died in heart failure, complicated by pulmonary infarction. The second died suddenly after discharge from the hospital, while maintained in good control of the congestive heart failure. The third patient had recurrence of congestive heart failure after discharge, which was controled by the hospitalization and change to different vasodilator agents. Favorable hemodynamic effects were readily seen following vasodilators in patients with confestive cardiomyopathy. However, on chronic use some tolerance to the agents was observed. This needs to be investigated as to the mechanism so these agents can be more effectively utilized in these patients who are usually resistant to the conventional mode of therapy.
D000328:Adult; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D004361:Drug Tolerance; D006333:Heart Failure / Q000150:complications; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents