Vasodilatadores orales en la insuficiencia cardíaca / Oral vasodilators in heart failure

RESUMO

Oral vasodilators have proved to be valuable drugs in the management of systolic or diastolic heart failure. They produce a clinical and hemodynamic relief of preload, afterload or both during the resting state or exercise. Although left ventricular hypertrophy is an adaptative response to myocardial stress, in the long run it becomes an independent risk factor leading to diastolic dysfunction. At present, pharmacological regression of ventricular hypertrophy has a prognostic importance. Of the large number of available vasodilators, angiotensin converting enzyme inhibitors have proved to be the most succesful drugs. They behave as afterload relievers, counteracting both the renin-angiotensin and adrenergic systems, but also are powerful inhibitors of cardiomyocite enlargement and interstitial connective tissue proliferation. This last structural change may revert the compromised diastolic function of the heart