Medical management of chronic heart failure: direct-acting vasodilators and diuretic agents.
Chronic heart failure (CHF) is a clinical syndrome characterized by left ventricular dysfunction secondary to the loss of functional cardiac contractile cells following some type of myocardial damage. In response to this cell loss, several hemodynamic and neurohormonal compensatory mechanisms are activated, which can become deleterious over time. Direct-acting vasodilators, however, can produce favorable hemodynamic effects in this setting by reducing ventricular wall stress. Furthermore, diuretics can promote the excretion of sodium and water, thereby relieving hypervolemia and circulatory congestion. This article examines the role of these two classes of agents in the pharmacologic management of CHF.
Cuny
J
J
Enger
E L
EL
D002908:Chronic Disease; D004232:Diuretics / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000451:nursing / Q000503:physiopathology; D006801:Humans; D014665:Vasodilator Agents / Q000627:therapeutic use*
D004232:Diuretics; D014665:Vasodilator Agents