1. Hemodynamic effects of nitroprusside on valvular aortic stenosis
- Author
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Ikram, Hamid, Low, Clive J.S., Crozier, Ian G., and Shirlaw, Teresa
- Subjects
Sodium nitroferricyanide -- Physiological aspects ,Aortic valve stenosis -- Physiological aspects ,Hemodynamics ,Blood vessels -- Dilatation ,Health - Abstract
The effects of acute reduction of left ventricular (LV) loading in valvular aortic stenosis (AS) were examined. Thirty-five consecutive patients with AS (peak-to-peak aortic valve gradient 66 [+ or -] 26 mm Hg, aortic valve area 0.65 [+ or -] 0.22 [cm.sup.2]) were given intravenous sodium nitroprusside (1 to 3 [mu]g/kg/min) to reduce systolic aortic pressures by >10 mm Hg (mean aortic pressure 99 [+ or -] 15 to 80 [+ or -] 15 mm Hg; p Overall, nitroprusside infusion resulted in little change in cardiac index (2.72 [+ or -] 0.61 to 2.67 [+ or -] 0.58 liters/min/[m.sup.2]; p = not significant). Individual patients had a range of responses. Fourteen patients (group 1) had an increase in cardiac index (2.42 [+ or -] 0.59 to 2.74 [+ or -] 0.67 liters/min/[m.sup.2]; p It is concluded that there is a disparate response to acute vasodilatation in AS. Potentially beneficial effects are seen in a subgroup of patients, especially those with increased filling presures and impaired LV function. It is postulated that the hemodynamic effects of sodium nitroprusside in patients with AS can be explained by the balance of effects on preload and afterload.
- Published
- 1992