Abstract |
Although surgical therapy is effective for reducing excessive left ventricular (LV) afterload in valvular aortic stenosis (AS), salutary short-term medical treatment has been lacking. Since we have shown LV systolic pressure (SP) is altered concordant with arterial SP in AS by vasopressors, the present study evaluated efficacy of nitroprusside (NP) on LV function, energetics, and perfusion in 15 severe AS patients. NP infusion (average 33 micron/min) proved beneficial in each: LVSP 192 mm Hg was reduced to 164; arterial SP decrement equaled LVSP change; LV end-diastolic pressure 19 mm Hg declined to 10: cardiac index (2.73 L/min/m2) and heart rate were unaltered; total systemic vascular resistance 1433 dsc-5 decreased to 1201; elevated LV stroke work index 92 gm.m/m2 was diminished to 74. Simultaneously, LV O2 consumption fell, LV diastolic flow was unchanged, while subendocardial perfusion increased. Thus cautious NP therapy with careful monitoring provided marked reduction of LV affected and improved LV function, energetics, and coronary flow distribution.
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Authors | N A Awan, A N DeMaria, R R Miller, E A Amsterdam, D T Mason |
Journal | American heart journal
(Am Heart J)
Vol. 101
Issue 4
Pg. 386-94
(Apr 1981)
ISSN: 0002-8703 [Print] United States |
PMID | 7211666
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Ferricyanides
- Nitroprusside
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Topics |
- Aged
- Aortic Valve Stenosis
(complications, drug therapy)
- Blood Pressure
(drug effects)
- Cardiac Output
(drug effects)
- Coronary Disease
(complications, drug therapy)
- Female
- Ferricyanides
(therapeutic use)
- Heart Rate
(drug effects)
- Heart Ventricles
(physiopathology)
- Humans
- Male
- Middle Aged
- Nitroprusside
(therapeutic use)
- Oxygen Consumption
(drug effects)
- Stroke Volume
(drug effects)
- Vascular Resistance
(drug effects)
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