title: New perspectives of nitric oxide donors in cardiac arrest and cardiopulmonary resuscitation treatment.
abstract: Nitric oxide (NO) is often used to treat heart failure accompanied with pulmonary edema. According to present knowledge, however, NO donors are contraindicated when systolic blood pressure is less than 90 mmHg. Based on recent findings and our own clinical experience, we formulated a hypothesis about the new breakthrough complex lifesaving effects of NO donors in patients with cardiac arrest and cardiopulmonary resuscitation therapy. It includes a direct hemodynamic effect of NO donors mediated through vasodilation of coronary arteries in cooperation with improvement of cardiac function and cardiac output through reversible inhibition of mitochondrial complex I and mitochondrial NO synthase, followed by reduction in reactive oxygen species and correction of myocardial stunning. Simultaneously, an increase in vascular sensitivity to sympathetic stimulation could lead to an increase in diastolic blood pressure. Confirmation of this hypothesis in clinical practice would mean a milestone in the treatment for cardiac arrest and cardiopulmonary resuscitation.
authors.affiliation: Institute of Normal and Pathological Physiology and Centre of Excellence for Regulatory Role of Nitric Oxide in Civilization Diseases, Slovak Academy of Sciences, Bratislava, Slovak Republic, peter-kruzliak@post.sk.
authors.forename: Peter
authors.initials: P
authors.lastname: Kruzliak
authors.forename: Olga
authors.initials: O
authors.lastname: Pechanova
authors.forename: Tomas
authors.initials: T
authors.lastname: Kara
mesh_terms: D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002316:Cardiotonic Agents / Q000494:pharmacology; D016166:Free Radical Scavengers / Q000494:pharmacology; D006323:Heart Arrest / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008929:Mitochondria, Heart / Q000187:drug effects / Q000378:metabolism; D017682:Myocardial Stunning / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D020030:Nitric Oxide Donors / Q000378:metabolism / Q000494:pharmacology; D018384:Oxidative Stress / Q000187:drug effects
chemical_list: D002316:Cardiotonic Agents; D016166:Free Radical Scavengers; D020030:Nitric Oxide Donors