| Autor: |
Halperin, Jonathan L., Brooks, Kenneth M., Rothlauf, Elizabeth B., Mindich, Bruce P., Ambrose, John A., Teichholz, Louis E. |
| Zdroj: |
Journal of the American College of Cardiology; January 1985, Vol. 5 Issue: 1 p34-39, 6p |
| Abstrakt: |
Because the equality of the pulmonary artery wedge pressure and left atrial pressure has been questioned in patients with mitral valve disease and pulmonary hypertension, this study examined how vasomotor activity in the pulmonary capacitance vessels might contribute to a discrepancy between these pressures. The difference between the pulmonary wedge and left atrial pressures (designated as the pulmonary venous gradient) was measured after nitroglycerin administration in nine patients who had pulmonary hypertension (mean pulmonary artery pressure 40 mm Hg) after mitral valve replacement. Five minutes after sublingual nitroglycerin, 0.4 mg, the mean pulmonary wedge pressure decreased from 19 ± 2 to 13 ± 2 mm Hg (p < 0.005), exceeding the decrease in left atrial pressure (15 ± 2 to 11 ± 2 mm Hg; p < 0.005). Pulmonary blood flow increased from 4.6 ± 0.4 to 4.9 ± 0.4 liters/min (p < 0.005). The decrease in mean pulmonary venous gradient from 4.0 ± 0.8 to 1.7 ± 0.6 mm Hg (p < 0.025) was attributed to nitrate-mediated pulmonary venodilation. The ratio of venous gradient to blood flow, an index of pulmonary venous tone, decreased after nitroglycerin from 0.9 ± 0.2 to 0.4 ± 0.1 (p < 0.01). |
| Databáze: |
Supplemental Index |
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