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Effects of six-month afterload reduction therapy with hydralazine in chronic aortic regurgitation

J P Kleaveland, N Reichek, D M McCarthy

    The American Journal of Cardiology
    |May 1, 1986
    PubMed

    Insights

    Hydralazine therapy in chronic asymptomatic aortic regurgitation (AR) did not change left ventricular (LV) dimensions but improved systolic function and reduced end-systolic stress. However, LV mass increased, and drug intolerance was noted.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Chronic asymptomatic aortic regurgitation (AR) can lead to left ventricular (LV) remodeling.
    • Early intervention aims to prevent adverse LV changes.

    Purpose of the Study:

    • To evaluate the effect of 6-month hydralazine therapy on AR severity and LV remodeling in asymptomatic patients.
    • To assess changes in LV dimensions, hypertrophy, and systolic function.

    Main Methods:

    • 17 patients with chronic asymptomatic AR underwent echocardiography, radionuclide angiography, and exercise testing.
    • Patients received either maximal tolerated hydralazine dose or placebo in a double-blind manner for 6 months.

    Main Results:

    • Hydralazine reduced systolic blood pressure and end-systolic stress, improving LV fractional shortening.
    • LV mass increased with hydralazine, primarily due to increased end-diastolic wall thickness.
    • No significant changes were observed in LV dimensions or in the placebo group.

    Conclusions:

    • Hydralazine therapy in asymptomatic AR patients improved systolic function and reduced afterload but did not reverse LV enlargement.
    • Drug intolerance limited the effective treatment dose, and LV mass increased.
    • Further research is needed to determine the long-term impact and optimal use of hydralazine in AR.

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