What does this research mean for the field?

The combination of phentolamine and nitrates produces an additive reduction in ventricular filling pressures and increases cardiac output, making it an effective treatment for congestive heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the complementary hemodynamic effects of combining phentolamine with topical nitroglycerin in congestive heart failure.

September 1, 1981Angiology

Enhancement of Phentolamine by Nitrates in Patients with Congestive Heart Failure

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Why the study?

Does the addition of nitroglycerin ointment to phentolamine improve hemodynamics in patients with congestive heart failure?

Population

7 patients with congestive heart failure due to congestive cardiomyopathy

Comparison

Phentolamine 5 mg IV infusion at 0.3 mg/minute… vs Baseline and phentolamine alone

Design

Case_series

Follow-up

30 minutes after nitroglycerin application

Authors

LGLawrence GouldRutgers, The State University of New Jersey CRC.V.R. ReddyNewYork–Presbyterian Brooklyn Methodist Hospital BZBujung ZenWalter Reed Army Institute of Research

Discussion

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Implication

Suggests additive hemodynamic benefit from nitrates with phentolamine in heart failure; hypothesis-generating and requires prospective validation.

Key Points

To evaluate the complementary hemodynamic effects of combining phentolamine with topical nitroglycerin in congestive heart failure.
Conducted hemodynamic monitoring using a Swan-Ganz thermodilution catheter in N=7 patients with congestive heart failure secondary to congestive cardiomyopathy.
Administered an intravenous infusion of 5 mg phentolamine at 0.3 mg/min, followed by the topical application of 2.5 inches of nitroglycerin ointment to the chest with repeat measurements 30 minutes later.
Phentolamine infusion alone produced significant reductions in both right and left ventricular filling pressures along with a significant increase in cardiac output.
Subsequent application of nitroglycerin ointment produced a further reduction in right and left ventricular filling pressures.

Structured PICO

Does the addition of nitroglycerin ointment to phentolamine improve hemodynamics in patients with congestive heart failure?

Population

7 patients with congestive heart failure due to congestive cardiomyopathy

Intervention

Phentolamine 5 mg IV infusion at 0.3 mg/minute, followed by 2.5 inches of nitroglycerin ointment applied to the chest

Comparator

Baseline and phentolamine alone

Outcome

Hemodynamic measurements (right and left ventricular filling pressures and cardiac output) measured via Swan Ganz thermodilution cathetersurrogate

The combination of phentolamine and nitrates provides additive hemodynamic benefits by further reducing ventricular filling pressures in patients with congestive heart failure.

Cite This Study

Gould et al. (1981) studied this question.

synapsesocial.com/papers/6a1d9667cc9f7df1b705aae0 https://doi.org/10.1177/000331978103200902

Topics

HFrEF treatment Heart failure

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Implication

Suggests additive hemodynamic benefit from nitrates with phentolamine in heart failure; hypothesis-generating and requires prospective validation.

Enhancement of Phentolamine by Nitrates in Patients with Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Enhancement of Phentolamine by Nitrates in Patients with Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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