October 1, 1983European Heart Journal
Haemodynamic effects of frusemide and its influence on repetitive rapid volume loading in acute myocardial infarction
Why the study?
Does intravenous furosemide alter haemodynamics and left ventricular performance in male patients with left ventricular failure following acute myocardial infarction?
Key Points
- To evaluate the acute haemodynamic consequences of intravenous frusemide and its influence on left ventricular performance during rapid volume loading in acute myocardial infarction.
- Administered intravenous frusemide (1 mg/kg) to 22 male patients with left ventricular failure and radiographic pulmonary oedema following acute myocardial infarction.
- Tracked systemic arterial pressure, heart rate, left heart filling pressure, thermodilution cardiac output, and derived systemic vascular resistance for 90 minutes.
- Evaluated left ventricular responsiveness to passive leg raising (repetitive rapid volume loading) at baseline and at 30, 60, and 90 minutes post-dose.
- Frusemide produced immediate increases in systemic arterial pressure (P < 0.05) and heart rate (P < 0.05), followed by progressive drops in left heart filling pressure (P < 0.01), cardiac output (P < 0.01), and stroke volume (P < 0.05), alongside elevated systemic vascular resistance (P < 0.05).
- Patients achieved an average diuresis of 860 ml during the 90 minutes following intravenous administration.
- Passive leg raising failed to increase cardiac output at baseline, but elicited significant increases in cardiac output (P < 0.01) and stroke volume with decreased systemic vascular resistance (P < 0.05) at 90 minutes post-treatment.
Structured PICO
Does intravenous furosemide alter haemodynamics and left ventricular performance in male patients with left ventricular failure following acute myocardial infarction?
P
Population
22 male patients with left ventricular failure following acute myocardial infarction, with radiographic pulmonary oedema and average left heart filling pressure of 20 mmHg.
I
Intervention
Intravenous furosemide (frusemide) 1 mg/kg bolus injection.
C
Comparator
Baseline (pre-injection values) and control period passive leg raising.
O
Outcome
Haemodynamic changes including systemic arterial pressure, heart rate, left heart filling pressure, cardiac output, stroke volume, and systemic vascular resistance over 90 minutes.surrogate
Intravenous furosemide in acute myocardial infarction with heart failure reduces left heart filling pressure but also reduces cardiac output and stroke volume, reflecting initial venodilatation followed by blood volume depletion.
Authors
Discussion
No takes yet. Share an insight, caveat, or question.
Implication
Furosemide may lower filling pressure at the cost of reduced output in post-MI LV failure; leaves open net benefit in contemporary cohorts.
Cite This Study
Nelson et al. (1983) studied this question.