Beneficial long-term effects of hydralazine in aortic regurgitation

Article Abstract:

The aortic valve is a structure in the heart that directs the flow of blood from the left ventricle to the aorta, the major blood vessel carrying oxygen-containing blood to other vessels throughout the body. Aortic regurgitation (AR) is the backflow of blood into the left ventricle due to impaired function of the aortic valve. It results in increased mass and volume and decreased function of the left ventricle (LV). Irreversible damage to LV function may occur in patients with AR who are asymptomatic. Vasodilators are drugs that dilate blood vessels and may have beneficial effects in treating patients with AR. The long-term effectiveness of the vasodilator hydralazine in treating asymptomatic patients with AR was assessed in 19 patients, who were followed-up annually for a period of four years. Seven patients received 40 to 200 milligrams of hydralazine each day, whereas 12 patients were not given vasodilators. Among patients not receiving hydralazine, LV dimensions increased by 8 percent during the diastolic (relaxation) phase of the heart cycle, and by 13 percent during the systolic (contraction) phase of the heart cycle. Among patients receiving hydralazine, diastolic and systolic LV dimensions increased by 9 and 5 percent respectively before hydralazine treatment, and decreased by 7 and 7 percent, respectively after one year of drug therapy. These results demonstrate that hydralazine can delay dilation of the left ventricle in asymptomatic patients with AR. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Hydralazine, Aortic valve insufficiency, Heart ventricles

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Dyspnea: pathophysiologic basis, clinical presentation, and management

Article Abstract:

Dyspnea is defined as difficult, labored, and uncomfortable breathing. It is a subjective condition and may be interpreted differently in various clinical studies. There are several possible mechanisms for the development of dyspnea, which can be put into four categories: disturbance of chemosensitivity, pulmonary receptors, respiratory muscle receptors, and outgoing respiratory motor command. Dyspnea is a frequently a chief manifestation of respiratory and cardiac disease. Some patients may be more aware of the presence of dyspnea than others and this is a perplexing problem for clinicians. Since dyspnea is a subjective sensation, there may be variations in the level of dyspnea necessary for a specific degree of functional impairment to occur. Treatment of dyspnea rests on treatment of the underlying condition. Although bronchodilators are useful in relieving dyspnea in patients with asthma, they are not completely effective for patients with chronic obstructive pulmonary disease (COPD). Supplemental oxygen has resulted in a decrease in dyspnea and improved exercise tolerance in patients with COPD. Some patients have also had a decrease in dyspnea when seated near an open window or a fan. There is still a lot to learn about the causes of dyspnea in patients with cardiopulmonary diseases. Researchers still need to determine why some patients display more distress than others. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Physiological aspects, Respiratory tract diseases, Shortness of breath, Dyspnea

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