[Sodium nitroprusside in the treatment of left-sided heart failure in acute myocardial infarction (author's transl)].
27 patients (8 women, 19 men) aged 39-79 (mean 61) years with acute transmural mycoardial infarction and limitation of left ventricular function were treated in the acute stage for 24-72 (mean 55) hours with intravenous infusions of sodium nitroprusside in concentrations of 10-200 microng/min. Haemodynamic measurements before and 12 hours after onset of treatment showed a significant reduction in mean arterial pressure by 19%, in end-diastolic pressure in the pulmonary artery by 33% and in the total peripheral resistance by 32%, whereas stroke volume and cardiac index rose by 12% and 17%, respectively. The percentage improvement was most marked in those patients most severely affected. The mortality rate of cardiogenic shock was reduced to 25%. In a control group with haemodynamically similar left ventricular failure the mortality rate was 55%. However, the total mortality was nearly unchanged as the number of sudden unexpected deaths after the fourth day rose from 23 to 50%. Further investigations will show how these sudden deaths, mainly due to arrhythmias, can be prevented.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D005260:Female; D005292:Ferricyanides / Q000627:therapeutic use*; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D009599:Nitroprusside / Q000627:therapeutic use*; D011651:Pulmonary Artery; D012770:Shock, Cardiogenic / Q000188:drug therapy; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects
D005292:Ferricyanides; D009599:Nitroprusside
Natrium-Nitroprussid zur Therapie der Linksinsuffizienz beim akuten Herzinfarkt