The purpose of this study was to determine the long-term effects of chronic afterload reduction with oral hydralazine (H) in patients with primary myocardial disease (PMD). Twelve children aged 3 to 36 months presented with signs of severe heart failure. The PMD was confirmed by angiography. Each patient was treated with digoxin and diuretics. After obtaining control echocardiogram (ECHO), oral H was started on a small dose which was increased to 4.0 mglkglday. ECHOs were first repeated at 1-to 3-month intervals and later every 6 months. The follow-up period was from 3 to 30 months with a mean of 18 months. The pre-H ECHOs were compared with those at the last follow-up visit. The shortening fraction rose from 15
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