[Dihydralazine treatment of cardiac insufficiency in children]

The action, efficient dosage and tolerance of a pure vasodilator, dihydralazine, used for the treatment of severe heart failure were studied in 30 children aged 1 month to 14 years. All of them presented with heart failure from various causes, not controlled by the usual medical treatment. Dihydralazine was administered orally, without interrupting the digoxin-diuretic treatment, with a dose of 34 to 140 mg/m2/day given in 4 equal doses. Clinical efficacy was considered null in 12 cases, low in 12 cases and good in 6 cases, without relationship with the original heart defect. Five of the 6 good results were obtained with doses greater than or equal to 100 mg/m2/day. In the group of 16 children who were given doses greater than or equal to 100 mg/m2/day, a significant improvement of the ECG indexes of left ventricular performance was obtained: decrease in systolic left ventricular internal dimension (p less than 0.05 at day 5), increase of the shortening fraction (p less than 0.05 since day 1) and of velocity of shortening (p less than 0.01 since day 1), while the diastolic left ventricular internal dimension remained unchanged. The only transitory undesirable effects observed were headache, vomiting and/or rash in 9 cases.