Contribution of vasopressin to vasoconstriction in patients with congestive heart failure: Comparison with the renin-angiotensin system and the sympathetic nervous system
Key result
Arginine vasopressin V1 antagonist reduces systemic vascular resistance only when plasma vasopressin is elevated.
- n=10
Why the study?
The contribution of vasopressin to vasoconstriction in advanced congestive heart failure and its comparison with the renin-angiotensin system and sympathetic nervous system was unclear.
Does an arginine vasopressin V1 antagonist reduce systemic vascular resistance in patients with advanced congestive heart failure?
Comparison
Arginine vasopressin V1 antagonist vs captopril vs phentolamine
Design
Hemodynamic monitoring case series
Authors
Discussion
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Member takes
Implication
Does not support routine V1 antagonist use in heart failure; leaves open benefit in elevated-vasopressin subgroups.
Structured PICO
Does an arginine vasopressin V1 antagonist reduce systemic vascular resistance in patients with advanced congestive heart failure?
P
Population
10 patients with advanced congestive heart failure undergoing hemodynamic monitoring to assess mechanisms of vasoconstriction.
I
Intervention
Arginine vasopressin V1 antagonist, captopril, and phentolamine administered during hemodynamic monitoring
O
Outcome
Change in systemic vascular resistancesurrogate
Vasopressin contributes to vasoconstriction in advanced heart failure, particularly in patients with markedly elevated plasma vasopressin levels.
Cite This Study
Creager et al. (1986) studied advanced congestive heart failure (n=10). Arginine vasopressin V1 antagonist was evaluated on Decrease in systemic vascular resistance. An arginine vasopressin V1 antagonist decreased systemic vascular resistance only in patients with elevated plasma vasopressin, whereas captopril and phentolamine reduced it by 20% and 34%.