title: Therapeutic advances in heart failure.
abstract: Annual mortality from congestive heart failure ranges from 15% to 60%, depending on the severity of the left ventricular damage and underlying disease. Most controlled trials have been too small to detect any beneficial effect on survival from the newer vasodilator and inotropic drugs. However, the results of two recent studies strongly suggest that some vasodilator drugs improve prognosis. In one study, a hydralazine-nitrate combination reduced 2-year mortality by 34%, while in another study, enalapril, in addition to diuretics, digitalis, and directly acting vasodilators, reduced 1-year mortality by 31%. Thus far no large studies have been published with the new phosphodiesterase-inhibiting agents. Although preliminary reports of large-scale trials did not demonstrate changes in survival rate, they have been shown to improve well-being in class III-IV congestive heart failure patients.
authors.affiliation: Department of Cardiology, University Hospital, Freiburg im Breisgau, FRG.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.affiliation: Department of Cardiology, University Hospital, Freiburg im Breisgau, FRG.
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.affiliation: Department of Cardiology, University Hospital, Freiburg im Breisgau, FRG.
authors.forename: Hanjörg
authors.initials: H
authors.lastname: Just
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004656:Enalapril / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D014665:Vasodilator Agents; D004656:Enalapril
keywords: ACE inhibitors; digitalis; diuretics; phosphodiesterase inhibitors; prognosis; sudden cardiac death; survival