Afterload reduction therapy with nitroprusside in severe aortic regurgitation: Improved cardiac performance and reduced regurgitant volume
| Autor: | Dean T. Mason, Antone F. Salel, Richard R. Miller, Anthony N. DeMaria, Louis A. Vismara |
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| Rok vydání: | 1976 |
| Předmět: |
Male
Nitroprusside Cardiac output medicine.medical_specialty Cardiac Volume medicine.medical_treatment Aortic Valve Insufficiency Hemodynamics Blood Pressure Regurgitation (circulation) Afterload Heart Rate Internal medicine Humans Medicine Cardiac Output Ferricyanides Aged Cardiac catheterization business.industry Middle Aged Myocardial Contraction Blood pressure medicine.anatomical_structure Anesthesia cardiovascular system Vascular resistance Cardiology Female Vascular Resistance Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 38:564-567 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(76)80003-3 |
| Popis: | To assess the hemodynamic effects of afterload reduction in severe aortic regurgitation, nitroprusside was infused at cardiac catheterization in 12 patients with aortic regurgitation. Cardiac hemodynamics, angiographic variables and regurgitant volumes were quantified during control periods, and nitroprusside was infused to reduce systemic systolic pressure to 110 to 125 mm Hg. The following were reduced by the drug: systolic arterial pressure (from 154 +/- 6.4 to 115 +/- 2.3 mm Hg, P less than 0.001); left ventricular end-diastolic pressure (from 23 +/- 2.2 to 11 +/- 1.0 mm Hg, P less than 0.001); systemic vascular resistance (from 1,782 +/- 133 to 1,148 +/- 94 dynes sec cm-5, P less than 0.001); left ventricular end-diastolic volume (from 242 +/- 25 to 196 +/- 19 ml, P less than 0.001); aortic regurgitant fraction (from 0.53 +/- 0.05 to 0.44 +/- 0.06, P less than 0.01); and aortic regurgitant minute volume (from 5.5 +/- 0.10 to 4.3 +/- 0.09 liters/min, P less than 0.01). Effective cardiac index increased (from 2.49 +/- 0.19 to 3.10 +/- 0.24 liters/min per m2, P less than 0.01), and left ventricular ejection fraction rose (from 0.55 +/- 0.03 to 0.61 +/- 0.03, P less than 0.005). These data indicate that afterload reduction with nitroprusside in severe aortic regurgitation improves cardiac performance, greatly decreases left ventricular preload and reduces aortic regurgitant volume. Thus, nitroprusside therapy has special value in severe aortic regurgitation that is of particular benefit in critical clinical conditions. |
| Databáze: | OpenAIRE |
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