[Results of conventional treatment of severe congestive heart failure with vasodilators]

In 61 patients with NYHA IV class chronic congestive heart failure, treated in succession with digoxin (D) and furosemide (F) for two weeks, with D+F and isosorbide dinitrate (S) or nifedipine (N) for two weeks, with D+F+S or N without C for two weeks, clinical status, chest X-ray picture and two dimensional echocardiography were evaluated at the end of each stage of the treatment. There were analyzed heart rate (HR), arterial systolic (Ps) and diastolic (Pd) blood pressure, body weight (Mc), 24-hour urinary output (Dd), cardio-thoracic index (CTI), cardiac volume index (CVI) and dimensions of the left ventricle: systolic (LVIDs), and diastolic (LVIDd). The mean daily doses of the drugs were as follows: D-0.290 +/- 0.108 mg, F-13.0 +/- 4.1 mg, S-44.5 +/- 9.8 mg, N-42.0 +/- 12.2 mg, and C-75.1 +/- 24.4 mg. The treatment with vasodilators (Vd) induced decreases in Mc, CVI, LVIIDs and LVIDd in comparison with the treatment with D and F. The largest lowerings in HR, Ps, Pd and Mc were observed during the treatment with D and F. The most beneficial effects with regard to CVI, LVIDs and LVIDd were obtained during four-week treatment with captopril.