1971
DOI: 10.1016/s0140-6736(71)92098-8
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Phentolamine for Vasodilator Treatment of Severe Heart-Failure

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Cited by 268 publications
(40 citation statements)
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“…There was a gradual return to pretreatment Discussion Therapy for heart failure consisting of reducing the afterload with vasodilator drugs has recently been advocated either as an alternative or adjunct to the traditional approach of using diuretics and inotropic agents.9 It has been shown that diuretics which reduce ventricular filling pressure may in fact decrease the cardiac output.10 Inotropic drugs which increase the velocity of fiber shortening and the systolic arterial pressure will augment the oxygen demands of the myocardium," whereas drugs which reduce the impedance to left ventricular outflow may increase the cardiac output and relieve the left ventricular wall tension. A variety of parenteral and oral vasodilator agents have been studied, including sodium nitroprusside," phentolamine, 13 nitroglycerin, 14 hydralazine," and prazosin. 6 Their effects vary'7 in terms of duration of action, degree of dilatation of the venous or arterial vessels, sympathetic stimulation, and influence on regional blood flows, particularly coronary flow.…”
Section: Resultsmentioning
confidence: 99%
“…There was a gradual return to pretreatment Discussion Therapy for heart failure consisting of reducing the afterload with vasodilator drugs has recently been advocated either as an alternative or adjunct to the traditional approach of using diuretics and inotropic agents.9 It has been shown that diuretics which reduce ventricular filling pressure may in fact decrease the cardiac output.10 Inotropic drugs which increase the velocity of fiber shortening and the systolic arterial pressure will augment the oxygen demands of the myocardium," whereas drugs which reduce the impedance to left ventricular outflow may increase the cardiac output and relieve the left ventricular wall tension. A variety of parenteral and oral vasodilator agents have been studied, including sodium nitroprusside," phentolamine, 13 nitroglycerin, 14 hydralazine," and prazosin. 6 Their effects vary'7 in terms of duration of action, degree of dilatation of the venous or arterial vessels, sympathetic stimulation, and influence on regional blood flows, particularly coronary flow.…”
Section: Resultsmentioning
confidence: 99%
“…The reflex positive inotropic mechanism is probably also responsible for the lack of modification in dP/dT/LVEDP ratio. (Helfant, 1971;Harrison, 1978 (Franciosa, 1972;Majid, 1971;Gold, 1972). This therapeutic intervention should serve to emphasize the fact that cardiac performance and myocardial oxygen consumption are not always directly linked.…”
Section: Discussionmentioning
confidence: 99%
“…Hematologic and biochemical measurements made 24 hours after drug infusion were not different from those before drug administration. Discussion Hemodynamic benefit from afterload reduction in patients with congestive heart failure was first demonstrated by Majid et al 23 Since then, an improvement in cardiac output after administration of a variety of agents with widely diverse pharmacologic actions but that all reduce SVR has suggested the important role of excessive vasoconstriction in perpetuating low cardiac output in these patients. 24 In addition, greater impairment of blood flow to the kidney than to other regional vascular beds25 tends to increase the demands on the already compromised myocardium because the extracellular fluid volume expands due to impaired salt and water excretion by the kidney.…”
Section: Hemodynamic Measurementsmentioning
confidence: 94%