The long-term effects of
vasodilators in asymptomatic patients with
aortic regurgitation have not been studied extensively. We retrospectively reviewed the echocardiograms of 19 asymptomatic patients with significant
aortic regurgitation followed up annually for up to 4 years (average +/- SD, 3.1 +/- 0.7 years). Of these 19 patients, 12 were not receiving
vasodilators and 7 were receiving
hydralazine hydrochloride, 40 to 200 mg daily. In the patients not receiving
vasodilators, left ventricular diastolic and systolic dimensions increased progressively in all patients by an average of 8% and 13%, respectively, after 3 years. In the patients receiving
hydralazine, left ventricular dimensions increased by 9% and 5% in the year or more before
hydralazine use and decreased by 7% and 7%, respectively, during the first year after using
hydralazine. The reduction was observed in all patients during the first year, but an increase was detected in 3 patients followed up beyond that period. The results suggest that the progression of left ventricular dilatation in asymptomatic patients with
aortic regurgitation can be delayed by long-term
therapy with
vasodilators. Pending further confirmation, such
therapy may possibly influence the natural history of the disease and delay the timing of operation.