Hemodynamic effects of nitroprusside on valvular aortic stenosis

Ikram, Hamid; Low, Clive J.S.; Crozier, Ian; Shirlaw, Teresa

doi:10.1016/0002-9149(92)90234-p

Cited by 18 publications

(6 citation statements)

References 11 publications

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“…However, the validity of this concern is unclear because invasive hemodynamic studies have suggested that nitroprusside is well tolerated even in such patients. 19, 20 The results of our study are clinically relevant because it was a "real-life" study. The only exclusion criterion was hypotension, which precludes the administration of nitroprusside.…”

Section: Figure 2 Change In the Cardiac Index 24 Hours After The Stamentioning

confidence: 77%

“…In fact, small studies have documented beneficial hemodynamic effects of vasodilatation in asymptomatic patients with severe aortic stenosis and normal or slightly depressed left ventricular function. 19,20 However, the effect of vasodilatation in symptomat-ic patients with more severe ventricular dysfunction is unknown, since they have been excluded from these studies. We performed the Use of Nitroprusside in Left Ventricular Dysfunction and Obstructive Aortic Valve Disease (UNLOAD) Study to investigate the use of nitroprusside, a potent intravenous vasodilator, in critically ill patients with congestive heart failure and severe aortic stenosis.…”

mentioning

confidence: 99%

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Nitroprusside in Critically Ill Patients with Left Ventricular Dysfunction and Aortic Stenosis

Khot¹,

et al. 2003

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Section: Figure 2 Change In the Cardiac Index 24 Hours After The Stamentioning

confidence: 77%

mentioning

confidence: 99%

Nitroprusside in Critically Ill Patients with Left Ventricular Dysfunction and Aortic Stenosis

Khot¹,

et al. 2003

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“…Apesar das reservas acerca do uso de vasodilatadores em pacientes com EAo, estudos 140,190 indicaram aumento do índice cardíaco com o uso de nitroprussiato nos pacientes com insuficiência cardíaca aguda associada a essa valvopatia, sendo esse aumento demonstrado nos indivíduos com menor área valvar, menor fração de ejeção e menor índice cardíaco inicial 190 . Esse efeito poderia ser explicado pela diminuição -induzida pelo agente -da resistência vascular periférica, sabidamente aumentada em pacientes com insuficiência cardíaca aguda (ou crônica agudizada), com consequente aumento do débito cardíaco, apesar da estenose valvar.…”

Section: Insuficiência Cardíaca Aguda No Paciente Com Estenose Aórticunclassified

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Tarasoutchi¹,

Montera²,

Grinberg³

et al. 2011

Arq. Bras. Cardiol.

126

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Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim como os conceitos emitidos em artigos assinados são de exclusiva responsabilidade de seus autores, não refletindo necessariamente a opinião da SBC. Todos os direitos reservados e protegidos pela lei 9.610 de 19/02/98. Nenhuma parte desta publicação poderá ser reproduzida sem autorização prévia por escrito dos Editores, sejam quais forem os meio empregados: eletrônico, mecânico, fotográfico, gravação ou quaisquer outros. Material de distribuição exclusiva à classe médica. Os Arquivos Brasileiros de Cardiologia não se responsabilizam pelo acesso indevido a seu conteúdo e que contrarie a determinação em atendimento à Resolução da Diretoria Colegiada (RDC) nº 96/08 da Agência Nacional de Vigilância Sanitária (Anvisa), que atualiza o regulamento técnico sobre Propaganda, Publicidade, Promoção e informação de Medicamentos. Segundo o artigo 27 da insígnia, "a propaganda ou publicidade de medicamentos de venda sob prescrição deve ser restrita, única e exclusivamente, aos profissionais de saúde habilitados a prescrever ou dispensar tais produtos (...)". Garantindo o acesso universal, o conteúdo científico do periódico continua disponível para acesso gratuito e integral a todos os interessados no endereço: www.arquivosonline.com.br.

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“…In this case, the implication is that R 1 is large and that there is true aortic stenosis. Although vasodilators are usually avoided in aortic stenosis because of their potential for causing hypotension, we and others 18,21 have found it safe to use when administered cautiously in gradual dose increments.…”

Section: Distinguishing True From Pseudoaortic Stenosismentioning

confidence: 84%

Management of the Elderly Aortic Stenosis Patient With Low Gradient and Low Ejection Fraction

Carabello

2003

American J Geri Cardiology

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The incidence of aortic stenosis increases with age and thus it occurs frequently in elderly patients. Once severe obstruction has developed, death occurs within 3 years unless the aortic valve is replaced. The results of aortic valve surgery, even in octogenarians, are usually excellent in the absence of comorbidity. The exception to this rule is for the aortic stenosis patient who has low ejection fraction, a low cardiac output and a transvalvular gradient of <30 mm Hg. Such patients have far advanced left ventricular dysfunction and increased operative mortality. However, even these patients may benefit from surgery if they have truly severe aortic stenosis. Because valve area is unreliable at low cardiac outputs, output should be increased pharmacologically in such patients and the valve area recalculated. If the transvalvular gradient increases with output, severe aortic stenosis is present and valve replacement may be beneficial. However, if output increases but gradient does not, only mild stenosis is present and surgery is unlikely to prolong life.

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Hemodynamic effects of nitroprusside on valvular aortic stenosis

Cited by 18 publications

References 11 publications

Nitroprusside in Critically Ill Patients with Left Ventricular Dysfunction and Aortic Stenosis

Nitroprusside in Critically Ill Patients with Left Ventricular Dysfunction and Aortic Stenosis

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Management of the Elderly Aortic Stenosis Patient With Low Gradient and Low Ejection Fraction

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