ABSTRACT

Principles of vasodilator therapy in heart failure As discussed in Chapter 3, the syndrome of HF is associated with chronic neurohormonal activation, with the subsequent increase in systemic vascular resistance ultimately diminishing cardiac performance further. Direct arteriolar dilatation may be expected, therefore, to improve cardiac performance. As previously noted, the ability of the failing heart to adapt to increased preload (Frank-Starling relationship) is diminished. Venous dilatation reduces cardiac filling pressures by decreasing venous return.