Key result
Nitroprusside cuts pulmonary vascular resistance ~40% in acute pulmonary embolism.
Why the study?
PAWR has attracted attention as a noninvasive approach for the early detection of PH, but its changes in acute pulmonary embolism and response to vasodilator therapy required investigation.
Does nitroprusside administration reduce pulmonary artery wave reflection and pulmonary vascular resistance in a dog model of acute pulmonary embolism?
Does nitroprusside administration reduce pulmonary artery wave reflection and pulmonary vascular resistance in a dog model of acute pulmonary embolism?
Pulmonary artery wave reflection (PAWR) correlates with pulmonary vascular resistance and right ventricular function, suggesting it may serve as a sensitive, early indicator of right ventricular afterload changes in acute pulmonary embolism.
May warrant investigation of nitroprusside in acute pulmonary embolism; leaves open translation from this animal model to humans.
Pulmonary hypertension (PH) is a complex syndrome that has been frequently diagnosed in dogs and humans and can be detected by Doppler echocardiography and invasive catheterization. Recently, PAWR attracts much attention as a noninvasive approach for the early detection of PH. The present study aims to investigate the PAWR changes in acute pulmonary embolism (APE) and highlight the response of PAWR variables to vasodilator therapy in dogs. For this purpose, anesthesia and catheterization were performed in 6 Beagle dogs. After that, APE was experimentally conducted by Dextran microsphere administration, followed by vasodilator (Nitroprusside; 1μg/kg/min/IV) administration. The hemodynamics, echocardiography, PVR and PAWR variables were evaluated at the baseline, after APE and after administration of nitroprusside. The result showed a significant increase in PVR, PAP, tricuspid regurgitation (TR) as well as PAWR variables following APE induction compared with the baseline (p < 0.05). Vasodilation caused by administration of nitroprusside reduced the mean atrial pressure, PVR and PAWR parameters. There were a significant correlation and linear regression between PAWR indices and PVR as well as right ventricular function parameters. In conclusion, PAWR is not only correlated with PVR but also the right ventricular function parameter, which indicates that PAWR may be useful as a new evaluation method in PH, considering that PAWR can assess both right ventricular afterload and right ventricular function.
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Yoshida et al. (2021) studied Acute pulmonary embolism (n=6). Nitroprusside vs. Baseline (pre-treatment APE state) was evaluated on Pulmonary vascular resistance (PVR) in Woods units (p=0.02). In a dog model of acute pulmonary embolism, nitroprusside administration significantly decreased pulmonary vascular resistance from 16 to 9.6 Woods units (p=0.02) and reduced wave reflection parameters.
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