The effects of phentolamine and nitroglycerin on right-sided hemodynamics in cardiac patients can be explained by a shift of the systemic venous return curve and right-ventricular output curve
| Autor: | Hiroyasu Ito, Masao Kakami, Hiroko Watanabe, Kiyoji Asano, Yoko Imai, Hisaya Iguchi, Senri Hirakawa, Masatoshi Koshiji, Shinya Minatoguchi |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Cardiac output
Epinephrine Physiology Cardiac index Hemodynamics Nitroglycerin Norepinephrine Phentolamine Dogs Blood plasma Receptors Adrenergic beta medicine Animals Humans Cardiac Output Adrenergic alpha-Antagonists Heart Failure business.industry medicine.disease Heart failure Anesthesia Circulatory system Ventricular Function Right Cardiology and Cardiovascular Medicine business Venous return curve medicine.drug |
| Zdroj: | Japanese circulation journal. 56(8) |
| ISSN: | 0047-1828 |
| Popis: | The present study investigated the effects of phentolamine (PH) and nitroglycerin (NG) on the hemodynamics of the right heart in patients with cardiac disease. The patients were divided into a well-functioning left heart group (W group, n = 15) and a poorly-functioning left heart group (P group, n = 15). Right cardiac hemodynamic parameters and plasma noradrenaline (NA) and adrenaline (A) concentrations were measured before and after administering PH (0.1 mg/kg, i.v.) or NG (0.6 mg, sublingual). In a parallel animal study we obtained a systemic venous return curve by measuring mean circulatory pressure (MCP), mean right atrial pressure (RAP) and cardiac output, before and after administering PH (0.1 mg/kg, i.v.) or NG (12.5 micrograms/kg, i.v.) to anesthetized open-chest dogs (n = 14). We used MCP data (W group: 7.5 mmHg, P group: 10 mmHg) obtained in a separate series of human studies in our laboratory. We constructed the venous return curve by connecting the MCP point on abscissa with the cardiac index (CI)-RAP plot obtained in the clinical study. We also constructed the right ventricular output curve by connecting the point of -2 mmHg on the abscissa with the CI-RAP plot. We obtained the following results: (1) PH shifted the CI-RAP plot to the left and upwards, while NG shifted the CI-RAP plot to the left almost horizontally on the CI-RAP plane, where CI was plotted on ordinate and RAP on abscissa. The length [formula: see text] C = control point, PH = point after PH) of the shift of CI-RAP plot due to PH was greater in the P group than in W group, while there was no difference in the length [formula: see text] C = control point, NG = point after NG) of the shift of CI-RAP plot due to NG between P and W groups. (2) Both PH and NG significantly elevated plasma NA and A concentrations in both the W and P groups. In the P group, PH increased the plasma NA concentration significantly more than did NG, but both drugs increased plasma A concentration to a similar extent. (3) Both PH and NG significantly decreased the mean pulmonary arterial pressure with NG doing so significantly more than PH.(ABSTRACT TRUNCATED AT 400 WORDS) |
| Databáze: | OpenAIRE |
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