THE EFFICACY OF NITRATES IN ACUTE AND CHR ONIC HEART-FAILURE

For nitrates their efficacy in acute and chronic heart failure has to be differentiated. In acute heart failure the hemodynamic and symptoma tic improvements after administration of short term nitrate therapy re nder this form of therapy a standard medication. In contrast, the ther apy with nitrates in chronic heart failure has not significantly impro ved prognosis especially when compared with ACE-inhibitors. On the con trary, nitrates in chronic heart failure tend to increase the sympathe tic tone which is negatively correlated to survival. Thus, nitrates ar e only adjunctive therapy in patients with chronic heart failure.