title: Non-invasive measurement of the haemodynamic effects of inhaled salbutamol, intravenous L-arginine and sublingual nitroglycerin.
abstract: OBJECTIVE
  To examine the effects of salbutamol and L-arginine, two compounds acting largely on the endothelium, and the endothelium-independent agent nitroglycerin on blood pressure, arterial compliance, cardiac function and vascular resistance.
  
  
  METHODS
  Continuous radial pulse wave analysis, whole-body impedance cardiography, and plethysmographic blood pressure from fingers in the supine position and during head-up tilt were recorded in nine healthy subjects. Data were captured before and after L-arginine (10 mg mg(-1) min(-1)) or saline infusion, salbutamol (400 microg) or placebo inhalation, and sublingual nitroglycerin (0.25 mg) or placebo resoriblet.
  
  
  RESULTS
  The results of all measurements were comparable before drug administration. The effects of inhaled salbutamol were apparent in the supine position: systemic vascular resistance (-9.2 +/- 2.6%) and augmentation index (-4.0 +/- 1.5%) decreased, and heart rate (8.6 +/- 2.5%) and cardiac output (8.8 +/- 3.1%) increased. L-arginine had no clear effects on supine haemodynamics, but during head-up tilt blood pressure was moderately decreased and reduction in aortic reflection time prevented, indicating improved large arterial compliance. Nitroglycerin reduced supine vascular resistance (-6.7 +/- 1.8%) and augmentation index (-7.4 +/- 1.6%), and increased cardiac output (+9.2 +/- 2.7%). During head-up tilt, nitroglycerin increased cardiac output (+10.6 +/- 5.6%) and heart rate (+40 +/- 7.5%), decreased vascular resistance (-7.8 +/- 5.8%) and augmentation index (-18.7 +/- 3.2%), and prevented the decrease in aortic reflection time.
  
  
  CONCLUSIONS
  Inhaled salbutamol predominantly changed supine haemodynamics, whereas the moderate effects of L-arginine were observed during the head-up tilt. In contrast, small doses of nitroglycerin induced major changes in haemodynamics both supine and during the head-up tilt. Altogether, these results emphasize the importance of haemodynamic measurements in both the supine and upright positions.
authors: Department of Internal Medicine, University of Tampere, Tampere, Sweden. anna.tahvanainen@uta.fi
authors: Anna
authors: A
authors: Tahvanainen
authors: Miia
authors: M
authors: Leskinen
authors: Jenni
authors: J
authors: Koskela
authors: Erkki
authors: E
authors: Ilveskoski
authors: Juha
authors: J
authors: Alanko
authors: Mika
authors: M
authors: Kähönen
authors: Tiit
authors: T
authors: Kööbi
authors: Lauri
authors: L
authors: Lehtimäki
authors: Eeva
authors: E
authors: Moilanen
authors: Jukka
authors: J
authors: Mustonen
authors: Ilkka
authors: I
authors: Pörsti
mesh_terms: D000328:Adult; D000420:Albuterol / Q000494:pharmacology*; D001120:Arginine / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D002307:Cardiography, Impedance / Q000187:drug effects; D004333:Drug Administration Routes; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D009569:Nitric Oxide; D005996:Nitroglycerin / Q000494:pharmacology*; D016683:Supine Position; D018667:Tilt-Table Test; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D009569:Nitric Oxide; D001120:Arginine; D005996:Nitroglycerin; D000420:Albuterol