Aortic and pulmonary input impedance in patients with cor pulmonale.
The hydraulic load of the right and left ventricles and the clinical effects of nifedipine were evaluated in 8 normal subjects (mean age: 55 years) and 8 patients with cor pulmonale secondary to chronic obstructive lung disease (mean age: 57 years). It was found that there were differences in the right ventricular resistance (174.62 +/- 25.96 vs 468.57 +/- 178.81 dyne/sec/cm-5), first zero crossing frequency (3.62 +/- 0.34 vs 6.07 +/- 3.56 Hz), steady power (218.95 +/- 32.25 vs 359.44 +/- 37.46 mW) and total power of right ventricle (275.81 +/- 36.18 vs 440.46 +/- 85.16 mW) between the normal and cor pulmonale patients, respectively. However, no significant changes in characteristic impedance, pulsatile power or aortic impedance were observed in the right pulmonary artery. After administration of nifedipine to patients with cor pulmonale, there were significant changes in resistance (468.57 +/- 178.81 vs 256.36 +/- 178.56 dyne/sec/cm-5), steady power (359.44 +/- 37.46 vs 225.51 +/- 114.64) and total power (440.46 +/- 85.16 vs. 289.27 +/- 50.85) of the pulmonary artery, respectively. Otherwise there were no significant changes in aortic input impedance or characteristic impedance of right pulmonary artery and pulsatile power. In conclusion, we found that: 1) the hydraulic vascular load in the right ventricle was higher in patients with cor pulmonale, 2) characteristic impedance that was not increased in cor pulmonale patients may be due to a dilated pulmonary artery, 3) there was no impedance mismatch between left ventricle and systemic arterial system in patients with cor pulmonale, and 4) by reducing the pulmonary vascular resistance through nifedipine administration, the total external right ventricular power might be reduced, without affecting the proximal pulmonary arterial compliance.
Chen
Y T
YT
Division of Cardiology, Taichung Veterans General Hospital, National Yung-Ming Medical College, Chung Shan Medical and Dental College, Taiwan, Republic of China.
Chen
K S
KS
Chen
J S
JS
Lin
W W
WW
Hu
W H
WH
Chang
M K
MK
Lee
D Y
DY
Lee
Y S
YS
Lin
J R
JR
Chiang
B N
BN
D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000503:physiopathology*; D011660:Pulmonary Heart Disease / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D012016:Reference Values; D014655:Vascular Resistance / Q000187:drug effects
D009543:Nifedipine