Hemodynamic responses to combined therapy with captopril and hydralazine in patients with severe heart failure

B. M. Massie, M. Packer, J. T. Hanlon, D. T. Combs

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The hemodynamic benefits and safety of combined therapy with captopril and hydralazine were studied during invasive hemodynamic monitoring in 14 patients with severe heart failure. In eight patients, the individual effects of both drugs were evaluated before the administration of combined therapy, whereas hydralazine was added to maintenance captopril therapy in the other six patients. In the first group, captopril alone produced a marked decrease in pulmonary wedge pressure (28 ± 4 to 18 ± 5 mm Hg) and mean arterial pressure (85 ± 20 to 69 ± 13 mm Hg) (both p < 0.001) without a significant increase in cardiac index. Hydralazine alone produced a marked increase in cardiac index (1.6 ± 0.4 to 2.7 ± 0.5 liters/min per m2) (p < 0.001), but with a minimal decrease in pulmonary wedge pressure (28 ± 4 to 23 ± 4 mm Hg) (p < 0.05) and without a significant change in mean arterial pressure. The combination of captopril and hydralazine produced an increase in cardiac index similar to that of hydralazine alone and decreases in pulmonary wedge pressure and mean arterial pressure similar to those with captopril alone. Most important, when hydralazine was added to captopril in the entire group of 14 patients, cardiac index increased markedly with little additional decrease in mean arterial pressure and no significant increase in heart rate. The one patient who experienced symptomatic hypotension with combination therapy also had dizziness with captopril alone. Seven of the nine patients maintained on long-term treatment experienced symptomatic improvement. Thus, in patients with severe chronic heart failure, the combined use of captopril and hydralazine is feasible and produces acute hemodynamic improvement superior to that from either drug alone.

Original languageEnglish (US)
Pages (from-to)338-344
Number of pages7
JournalJournal of the American College of Cardiology
Volume2
Issue number2
StatePublished - 1983

Fingerprint

Hydralazine
Captopril
Heart Failure
Hemodynamics
Pulmonary Wedge Pressure
Arterial Pressure
Therapeutics
Dizziness
Pharmaceutical Preparations
Hypotension
Heart Rate
Maintenance
Safety

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Hemodynamic responses to combined therapy with captopril and hydralazine in patients with severe heart failure. / Massie, B. M.; Packer, M.; Hanlon, J. T.; Combs, D. T.

In: Journal of the American College of Cardiology, Vol. 2, No. 2, 1983, p. 338-344.

Research output: Contribution to journalArticle

@article{1c7c36535e7f485c9fac2d4fb74b7f99,
title = "Hemodynamic responses to combined therapy with captopril and hydralazine in patients with severe heart failure",
abstract = "The hemodynamic benefits and safety of combined therapy with captopril and hydralazine were studied during invasive hemodynamic monitoring in 14 patients with severe heart failure. In eight patients, the individual effects of both drugs were evaluated before the administration of combined therapy, whereas hydralazine was added to maintenance captopril therapy in the other six patients. In the first group, captopril alone produced a marked decrease in pulmonary wedge pressure (28 ± 4 to 18 ± 5 mm Hg) and mean arterial pressure (85 ± 20 to 69 ± 13 mm Hg) (both p < 0.001) without a significant increase in cardiac index. Hydralazine alone produced a marked increase in cardiac index (1.6 ± 0.4 to 2.7 ± 0.5 liters/min per m2) (p < 0.001), but with a minimal decrease in pulmonary wedge pressure (28 ± 4 to 23 ± 4 mm Hg) (p < 0.05) and without a significant change in mean arterial pressure. The combination of captopril and hydralazine produced an increase in cardiac index similar to that of hydralazine alone and decreases in pulmonary wedge pressure and mean arterial pressure similar to those with captopril alone. Most important, when hydralazine was added to captopril in the entire group of 14 patients, cardiac index increased markedly with little additional decrease in mean arterial pressure and no significant increase in heart rate. The one patient who experienced symptomatic hypotension with combination therapy also had dizziness with captopril alone. Seven of the nine patients maintained on long-term treatment experienced symptomatic improvement. Thus, in patients with severe chronic heart failure, the combined use of captopril and hydralazine is feasible and produces acute hemodynamic improvement superior to that from either drug alone.",
author = "Massie, {B. M.} and M. Packer and Hanlon, {J. T.} and Combs, {D. T.}",
year = "1983",
language = "English (US)",
volume = "2",
pages = "338--344",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Hemodynamic responses to combined therapy with captopril and hydralazine in patients with severe heart failure

AU - Massie, B. M.

AU - Packer, M.

AU - Hanlon, J. T.

AU - Combs, D. T.

PY - 1983

Y1 - 1983

N2 - The hemodynamic benefits and safety of combined therapy with captopril and hydralazine were studied during invasive hemodynamic monitoring in 14 patients with severe heart failure. In eight patients, the individual effects of both drugs were evaluated before the administration of combined therapy, whereas hydralazine was added to maintenance captopril therapy in the other six patients. In the first group, captopril alone produced a marked decrease in pulmonary wedge pressure (28 ± 4 to 18 ± 5 mm Hg) and mean arterial pressure (85 ± 20 to 69 ± 13 mm Hg) (both p < 0.001) without a significant increase in cardiac index. Hydralazine alone produced a marked increase in cardiac index (1.6 ± 0.4 to 2.7 ± 0.5 liters/min per m2) (p < 0.001), but with a minimal decrease in pulmonary wedge pressure (28 ± 4 to 23 ± 4 mm Hg) (p < 0.05) and without a significant change in mean arterial pressure. The combination of captopril and hydralazine produced an increase in cardiac index similar to that of hydralazine alone and decreases in pulmonary wedge pressure and mean arterial pressure similar to those with captopril alone. Most important, when hydralazine was added to captopril in the entire group of 14 patients, cardiac index increased markedly with little additional decrease in mean arterial pressure and no significant increase in heart rate. The one patient who experienced symptomatic hypotension with combination therapy also had dizziness with captopril alone. Seven of the nine patients maintained on long-term treatment experienced symptomatic improvement. Thus, in patients with severe chronic heart failure, the combined use of captopril and hydralazine is feasible and produces acute hemodynamic improvement superior to that from either drug alone.

AB - The hemodynamic benefits and safety of combined therapy with captopril and hydralazine were studied during invasive hemodynamic monitoring in 14 patients with severe heart failure. In eight patients, the individual effects of both drugs were evaluated before the administration of combined therapy, whereas hydralazine was added to maintenance captopril therapy in the other six patients. In the first group, captopril alone produced a marked decrease in pulmonary wedge pressure (28 ± 4 to 18 ± 5 mm Hg) and mean arterial pressure (85 ± 20 to 69 ± 13 mm Hg) (both p < 0.001) without a significant increase in cardiac index. Hydralazine alone produced a marked increase in cardiac index (1.6 ± 0.4 to 2.7 ± 0.5 liters/min per m2) (p < 0.001), but with a minimal decrease in pulmonary wedge pressure (28 ± 4 to 23 ± 4 mm Hg) (p < 0.05) and without a significant change in mean arterial pressure. The combination of captopril and hydralazine produced an increase in cardiac index similar to that of hydralazine alone and decreases in pulmonary wedge pressure and mean arterial pressure similar to those with captopril alone. Most important, when hydralazine was added to captopril in the entire group of 14 patients, cardiac index increased markedly with little additional decrease in mean arterial pressure and no significant increase in heart rate. The one patient who experienced symptomatic hypotension with combination therapy also had dizziness with captopril alone. Seven of the nine patients maintained on long-term treatment experienced symptomatic improvement. Thus, in patients with severe chronic heart failure, the combined use of captopril and hydralazine is feasible and produces acute hemodynamic improvement superior to that from either drug alone.

UR - http://www.scopus.com/inward/record.url?scp=0020606918&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0020606918&partnerID=8YFLogxK

M3 - Article

C2 - 6345633

AN - SCOPUS:0020606918

VL - 2

SP - 338

EP - 344

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 2

ER -