Which medications in the drug class Vasodilators are used in the treatment of Dilated Cardiomyopathy?

Updated: Nov 28, 2018
  • Author: Vinh Q Nguyen, MD, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Answer

Vasodilators

Preload reduction with venodilators is thought to be helpful in acute decompensated heart failure by reducing congestions and minimizing cardiac oxygen demand. Afterload reduction is also thought to be helpful in some patients with acute decompensated heart failure by decreasing myocardial oxygen demand and improving forward flow.

Sublingual nitroglycerin spray, nitropaste, and IV nitroglycerin have been advocated in the treatment of pulmonary edema secondary to CHF. Morphine also has significant vasodilatory effects and can be useful.

Hydralazine

Hydralazine decreases systemic resistance through direct vasodilation of arterioles.

Isosorbide dinitrate and hydralazine (BiDil)

This product is a fixed-dose combination of isosorbide dinitrate (20 mg/tab), a vasodilator with effects on both arteries and veins, and hydralazine (37.5 mg/tab), a predominantly arterial vasodilator. It is indicated for heart failure in black patients.

Nitroglycerin topical (Nitro-Bid, Nitro-Dur, Minitran)

Nitroglycerin causes relaxation of vascular smooth muscle by stimulating intracellular cyclic guanosine monophosphate (cGMP) production, resulting in a decrease in blood pressure.

Sacubitril/valsartan (Entresto)

Sacubitril-valsartan may replace ACE inhibitors in patients who are symptomatic on optimal heart failure therapy.

Ivabradine (Corlanor)

In patients with systolic heart failure with an LVEF below 35%, who are in sinus rhythm, have a resting heart rate more than 70 beats per minute, and are on maximally tolerated doses of beta-blockers or who were intolerant to beta blockers, ivabradine reduces cardiovascular death and hospital admission for worsened heart failure.


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