title: The role of venodilators in the perioperative management of heart failure.
abstract: A unifying hypothesis which satisfactorily explains the clinical syndrome of heart failure has proved elusive. A deeper understanding of the underlying pathophysiology has led to the development of more complex models and, as a result, the evolution of new treatment strategies. In patients undergoing non-cardiac surgery, perioperative heart failure has an incidence of approximately 1% and is a predictor of major adverse cardiovascular events. Although vasodilators undoubtedly play a major role in the management of patients with heart failure, the relative importance of venodilatation remains unclear. The purpose of this article is to discuss the clinical evidence supporting the use of drugs with venodilating properties in surgical patients with heart failure.
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK. kamen.valchanov@papworth.nhs.uk
authors.forename: Kamen P
authors.initials: KP
authors.lastname: Valchanov
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Arrowsmith
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use; D009599:Nitroprusside / Q000627:therapeutic use; D019990:Perioperative Care; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D009599:Nitroprusside; D006830:Hydralazine; D005996:Nitroglycerin