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Nitrates for congestive heart failure.

J N Cohn

    The American Journal of Cardiology
    |July 10, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Nitrates effectively treat congestive heart failure (CHF) by dilating blood vessels and reducing heart pressure. High doses are well-tolerated, improving exercise capacity and symptoms in CHF patients.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Nitrates are used to treat congestive heart failure (CHF).
    • Their efficacy stems from dilating capacitance vessels and reducing ventricular diastolic pressure.

    Purpose of the Study:

    • To review the use of nitrates in congestive heart failure (CHF) treatment.
    • To discuss the hemodynamic and clinical efficacy of nitrates, alone and in combination therapy.

    Main Methods:

    • Review of existing clinical trials and hemodynamic studies on nitrate therapy in CHF.
    • Assessment of nitrate efficacy based on ventricular filling pressure, jugular venous pressure, and clinical outcomes like exercise tolerance.

    Main Results:

    • Nitrates reduce preload and ventricular filling pressures, improving cardiac function in CHF.

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  • High doses of nitrates are generally well-tolerated in CHF patients.
  • Combination therapy with potent arteriolar dilators shows enhanced hemodynamic benefits.

    • Conclusions:

    • Nitrate therapy, at doses normalizing ventricular filling pressure, is recommended for CHF.
    • Monitoring jugular venous pressure is key to optimizing nitrate dosage.
    • Sustained hemodynamic effects may require high doses of isosorbide dinitrate or transdermal nitroglycerin.