[Effects of urapidil by intravenous injection on pulmonary circulation and cardiac function in left ventricular failure].
The hemodynamic effects of urapidil were studied in 10 patients with secondary pulmonary hypertension investigated for the purpose of possible inclusion on a heart transplant waiting list. All patients gave their consent to participate. Nine patients had a dilated cardiomyopathy and 1 three-vessel coronary disease with diffuse hypokinesia. All were treated with digitalis, diuretics, converting enzyme inhibitors or calcium antagonists. Hemodynamic effects were measured 5 and 25 minutes after the slow intravenous injection of 50 mg of urapidil. Urapidil caused a significant decrease in pulmonary pressures (-20%) and total pulmonary resistance (-42.5%). The fall in systemic arterial resistance was of the same degree (41.5%). The fall in pulmonary arterial resistance was also significant (-26%). The increase in cardiac output was +35%, with no change in left ventricular myocardial function indices. Thus, in patients with congestive left ventricular failure and secondary pulmonary hypertension already treated with vasodilators, urapidil resulted in a hemodynamic improvement after intravenous administration, demonstrating a synergistic action with that of other vasodilators. This synergistic action could be used to test pulmonary arteriolar vasodilatation reserves during the hemodynamic assessment of patients in whom a heart transplant is contemplated.
Service de Cardiologie, CHU Pitié-Salpêtrière, Paris.
G
G
Drobinski
G
G
Montalescot
J M
JM
Fossier
Y
Y
Grosgogeat
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy*; D004341:Drug Evaluation; D006321:Heart / Q000503:physiopathology*; D006334:Heart Function Tests; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D010879:Piperazines / Q000008:administration & dosage / Q000494:pharmacology*; D011652:Pulmonary Circulation / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects
D000959:Antihypertensive Agents; D010879:Piperazines; C015568:urapidil
Effets de l'urapidil en injection intraveineuse sur la circulation pulmonaire et la fonction cardiaque dans l'insuffisance ventriculaire gauche.