Abstract | BACKGROUND: METHODS AND RESULTS: Twenty-one patients with New York Heart Association class III-IV heart failure underwent infusion of 3 mg/kg enoximone over a period of 30 minutes. Before and after drug infusion, we determined the plasma concentrations of atrial natriuretic peptide, endothelin-I, angiotensin-II, aldosterone, norepinephrine, epinephrine, and angiotensin-converting enzyme activity sampled from a peripheral vein and the pulmonary artery. In addition to the expected significant reduction of pulmonary hypertension and enhancement of cardiac output, increased levels of the vasoconstrictors endothelin-I, angiotensin-II, and norepinephrine were observed. Aldosterone fell after enoximone infusion; a higher baseline aldosterone level correlated to the degree of reduction of the pulmonary arteriolar resistance by enoximone. Baseline atrial natriuretic peptide levels correlated with parameters, indicating the severity of heart failure. However, the plasma concentration of this peptide did not change significantly after enoximone infusion. CONCLUSIONS: Acute hemodynamic improvement after enoximone bolus in candidates for heart transplantation is not accompanied by a reduction of the enhanced neurohumoral activity in these patients. The reaction of the investigated hormones cannot predict the individual degree of reversibility of pulmonary hypertension.
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Authors | O Schulz, V Mitrovic, M Schönburg, J Thormann |
Journal | American heart journal
(Am Heart J)
Vol. 137
Issue 5
Pg. 887-94
(May 1999)
ISSN: 0002-8703 [Print] United States |
PMID | 10220638
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biomarkers
- Catecholamines
- Endothelin-1
- Phosphodiesterase Inhibitors
- Angiotensin II
- Atrial Natriuretic Factor
- Enoximone
- Peptidyl-Dipeptidase A
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Topics |
- Angiotensin II
(blood)
- Atrial Natriuretic Factor
(blood)
- Biomarkers
(blood)
- Cardiac Catheterization
- Catecholamines
(blood)
- Endothelin-1
(blood)
- Enoximone
(administration & dosage)
- Female
- Heart Failure
(blood, complications, drug therapy)
- Hemodynamics
(drug effects)
- Humans
- Hypertension, Pulmonary
(blood, drug therapy, etiology)
- Infusions, Intravenous
- Male
- Middle Aged
- Peptidyl-Dipeptidase A
(blood)
- Phosphodiesterase Inhibitors
(administration & dosage)
- Prognosis
- Pulmonary Artery
- Pulmonary Veins
- Severity of Illness Index
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