Current concepts in vasodilator therapy for advanced or refractory congestive heart failure.

The use of vasodilators to assist in the management of advanced heart failure has gained widespread acceptance in human cardiology. The early experience with these same drugs in the management of heart failure in domestic animals has similarly been encouraging.Vasodilators function to favorably alter preload and afterload in the heart failure setting. Venodilators can resolve pulmonary edema by reducing an elevated left heart preload. Arterial vasodilators can increase stroke volume, reduce an elevated preload, and blunt or abolish the stimulation of the harmful compensatory measures that are induced in the presence of heart failure. Both classes require careful monitoring to ensure that marked hypotension does not occur.Vasodilator therapy can significantly complement other traditional modalities of drug therapy in cases of advanced heart failure.