Vasodilator therapy for right ventricular failure.
The effects of PGE1 and ISD on right ventricular performance in patients with pulmonary hypertension secondary to chronic lung disease were evaluated, and the following results were obtained. I) Effects of PGE1 on Right Ventricular Failure The effects of PGE1 (intravenous infusion, 0.01 to 0.03 microgram/kg/min) on right ventricular failure were studied in 12 patients with acute exacerbation of chronic respiratory failure. PGE1 resulted in a significant fall in RAP (p less than 0.05), PAMP (from 33.8 +/- 7.6 to 29.3 +/- 5.7 mmHg, p less than 0.005) and TPVR (p less than 0.001), whereas a significant increase in CI (from 3.4 +/- 0.6 to 3.9 +/- 0.6 1/min/m2, p less than 0.001) and SI (p less than 0.005). PaO2 was significantly decreased by PGE1 (p less than 0.02), however PvO2 remained unchanged because of a significant increase of O2-transport (p less than 0.01). PGE1 induced active vasodilation of the pulmonary vascular beds and reduced a right ventricular afterload. We concluded that PGE1 improved the right ventricular failure secondary to chronic lung disease. II) Effects of ISD on Right Ventricular Performance The effects of ISD (intravenous infusion, 0.05 mg/kg/hr) on right ventricular performance were studied at rest and during exercise in 11 patients with clinically stable chronic respiratory failure. At rest and during exercise, ISD induced a significant decrease in RAP, PAMP and CI, however no change in TPVR. RVWI was reduced significantly by ISD (from 2.5 +/- 0.8 to 1.9 +/- 0.5 Kg X m/min/m2, p less than 0.01) during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D000527:Alprostadil; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007263:Infusions, Parenteral; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000494:pharmacology; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D005082:Physical Exertion; D011458:Prostaglandins E / Q000008:administration & dosage* / Q000494:pharmacology; D011652:Pulmonary Circulation / Q000187:drug effects; D011660:Pulmonary Heart Disease / Q000150:complications; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000503:physiopathology; D014655:Vascular Resistance / Q000187:drug effects
D011458:Prostaglandins E; D000527:Alprostadil; D007548:Isosorbide Dinitrate; D010100:Oxygen