Clinical use of sodium nitroprusside in chronic ischemic heart disease. Effects on peripheral vascular resistance and venous tone and on ventricular volume, pump and mechanical performance.

Miller, Richard R.; Vismara, Louis A.; Zelis, Robert; Amsterdam, Ezra A.; Mason, Dean T.

doi:10.1161/01.cir.51.2.328

Cited by 197 publications

(27 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nitrovasodilators have been used since at least the mid-19th century (24) for the treatment of angina pectoris. More recently, nitrovasodilators have been used for the treatment of heart failure (25)(26)(27). Nitrovasodilators have also been shown to improve exercise tolerance in patients with severe congestive heart failure (25,26).…”

Section: Discussionmentioning

confidence: 99%

Endothelial nitric oxide synthase overexpression attenuates congestive heart failure in mice

Jones

Greer

Haperen

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

216

177

View full text Add to dashboard Cite

Congestive heart failure results in cardiovascular dysfunction and diminished vascular nitric oxide (NO) production. We hypothesized that overexpression of endothelial NO synthase (eNOS) within the endothelium would reduce the extent of contractile dysfunction in a murine model of infarct-induced congestive heart failure. We generated transgenic (TG) mice overexpressing the human eNOS gene. The TG mice displayed significantly enhanced eNOS protein levels and eNOS activity levels (10-to 12-fold greater) in the aorta and the coronary vasculature. Non-TG (NTg) and eNOS TG mice were subjected to permanent left anterior descending coronary artery occlusion and then observed for 1 mo. We assessed cardiac function in vivo by using echocardiography and ultraminiature ventricular pressure catheters. Myocardial infarct size was similar between study groups (Ϸ70% of the risk zone). Survival was increased by 43% in the eNOS TG mice compared with NTg (P < 0.05). Fractional shortening and cardiac output were also significantly (P < 0.05) greater in the eNOS TG than in NTg. Interestingly, pulmonary edema was evident only in NTg mice, and no evidence of pulmonary edema was observed in the eNOS TG mice. Thus, targeted overexpression of the eNOS gene within the vascular endothelium in mice attenuates both cardiac and pulmonary dysfunction and dramatically improves survival during severe congestive heart failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Endothelial nitric oxide synthase overexpression attenuates congestive heart failure in mice

Jones

Greer

Haperen

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

216

177

View full text Add to dashboard Cite

show abstract

“…This lias been attril)blted to smaller ventricular volunmes restiltinig f'rom reltiction in afterl oad (witli better systolic emptying) aindl preload (duie to venouis (lilatation), but (lemionistrationi that tihe lower filling pressuri-es are in faect ai consequienice of' smaller ventricuilar volumes has not been reported. Althouigh tihere have been a numl)er of stutdlies conceriiing tihe ef'fects of sodiuim nitroprtisside on left ventricular systolic perf'oriiaince (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) +dP/dt-peak positive dP/dt; -dP/dt-peak negative dP/dt; EDV-left ventricular end-diastolic volume; ESV-left ventricular endsystolic volume; EF-ejection fraction; DFRE-average diastolic filling rate during first one-third of diastole; DFRM-average diastolic filling rate during middle one-third of diastole; DFRL-average diastolic filling rate during last one-third of diastole; DFR-average diastolic filling rate during all of diastole.…”

mentioning

confidence: 99%

Effects of sodium nitroprusside on left ventricular diastolic pressure-volume relations.

Brodie¹,

Grossman²,

Mann³

et al. 1977

J. Clin. Invest.

140

View full text Add to dashboard Cite

show abstract

“…'-2' Below this level, myocardial inefficiency may occur. 20 The association of mechanical ventilation and dobutamine can induce this theoretical side effect. A dopamine-dobutamine combination prevents this slight reduction in PCWP.…”

Section: Resultsmentioning

confidence: 99%

Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock.

Richard¹,

Ricôme

Rimailho³

et al. 1983

Circulation

142

View full text Add to dashboard Cite

SUMMARYIn eight mechanically ventilated patients in cardiogenic shock, we assessed the hemodynamic effects of an infusion of dopamine and dobutamine and evaluated its role in preventing the deleterious effects of administering each amine alone. Each patient received three infusions in a randomly assigned order: dopamine, 15 ,.tg/kg/min; dobutamine, 15 ,tg/kg/min; and a combination of dopamine, 7.S ,g/kg/min, and dobutamine, 7.5 ,ug/kg/min. Stroke volume index increased similarly with the three infusions, but dopamine alone increased oxygen consumption (p < 0.05 vs dobutamine alone and dopamine-dobutamine combined). The dopamine-dobutamine combination increased mean arterial pressure (p < 0.05 vs dobutamine), maintained pulmonary capillary wedge pressure within normal limits (p < 0.05 vs dopamine), and prevented the worsening of hypoxemia induced by dopamine (p < 0.05). The dopamine-dobutamine combination appears to be useful in the management of mechanically ventilated patients in cardiogenic shock.THE HEMODYNAMIC PICTURE of heart failure is characterized by a decrease in stroke volume and an increase in ventricular filling pressures. When acute pump failure is so severe that an adequate cardiac output cannot be maintained, hypotension supervenes despite the elevated peripheral resistance, and cardiogenic shock ensues. In this setting, diuretics and vasodilators cannot be used alone, and the therapeutic use of sympathomimetic amines such as dopamine and dobutamine is required.Dopamine, a precursor in the endogenous synthesis of norepinephrine, is a potent inotropic agent.I-1 It increases stroke volume both by a direct action and through the release of norepinephrine stores.4 When dopamine is used at a dose of 10-15 ig/kg/min, vasopressor effects appear. These effects are of particular value in patients with hypotension.5 However, an important side effect limits its use in cardiogenic shock: At a dose of 10 to 15 ,ug/kg/min, it may induce an increase in pulmonary capillary wedge pressure (PCWP). As a result, its use may be associated with pulmonary vascular congestion, arterial desaturation and increase in venous admixture.6 Dobutamine is also a potent inotropic agent that acts directly on adrenergic myocardial receptors without any release of norepinephrine from nerve endings.' In the treatment of severe heart failure, dobutamine induces an increase in cardiac output and stroke volume with a reduction of PCWP.6 In contrast to dopamine, dobutamine probably has minimal direct vascular activity even when it is used at higher dosages. However, a reduction in systemic arterial resistance (SAR), frequently accompanied by a slight fall in mean arterial pressure (MAP), generally occurs during dobutamine infusion in patients with chronic, low-output cardiac failure.8 This decrease in SAR may be due to a reduc- tion in compensatory vasoconstriction secondary to an improvement in stroke volume index (SVI). The aim of this study was to assess the efficacy of a combined dopamine-dobutamine infusion, 7.5 Ag/kgl min each, in t...

show abstract

Clinical use of sodium nitroprusside in chronic ischemic heart disease. Effects on peripheral vascular resistance and venous tone and on ventricular volume, pump and mechanical performance.

Cited by 197 publications

References 27 publications

Endothelial nitric oxide synthase overexpression attenuates congestive heart failure in mice

Endothelial nitric oxide synthase overexpression attenuates congestive heart failure in mice

Effects of sodium nitroprusside on left ventricular diastolic pressure-volume relations.

Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock.

Contact Info

Product

Resources

About