Key result
Nitric oxide linked to ~11% higher PAWP and worse hemodynamics vs. isosorbide dinitrate or iloprost.
Why the study?
The specificity of vasodilation effects of isosorbide dinitrate, nitric oxide, and inhaled iloprost in patients with severe left ventricle systolic dysfunction was not well characterized.
What are the specific hemodynamic effects of isosorbide dinitrate, nitric oxide, and inhaled iloprost during vasoreactivity testing in candidates for heart transplantation with severe LV systolic dysfunction?
Observational (n=124)
What are the specific hemodynamic effects of isosorbide dinitrate, nitric oxide, and inhaled iloprost during vasoreactivity testing in candidates for heart transplantation with severe LV systolic dysfunction?
In patients with severe LV systolic dysfunction, selective pulmonary vasodilation with nitric oxide can cause LV overload and decreased LV output, unlike isosorbide dinitrate or inhaled iloprost.
Nitric oxide may provoke LV overload during vasoreactivity testing in severe systolic dysfunction; observational data leaves open optimal agent selection.
Objective. To determine the specificity of the vasodilation of isosorbide dinitrate (ID), nitric oxide (NO), inhaled iloprost (iIlo). Materials and methods. Study included 190 vasoreactivity tests (ID, NO or iIlo, Swan-Ganz catheter) performed in 124 candidates for heart transplantation. Results. In the ID group mean PAP decreased by 22.8±14.7 %, in the NO - by 5.9±17.4 %, in the iIlo - by 14.6±15 %, PAWP in the ID group decreased by 29±17 %, in the iIlo - by 3.9±27.2 %, but in NO PAWP increased by 11±33.7 %. When using NO, SVI decreased from 23.8±7.9 to 22.4±6.7 ml/m 2 . When using D, SVI increased by 29.2±27.7 %, as well as in the iIlo by 20.6±24.5 %. Conclusion. Selective vasodilation of pulmonary vessels by NO caused LV overload and a decrease in LV output.
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Баутин et al. (2018) conducted an observational in Severe left ventricle systolic dysfunction (n=124). Isosorbide dinitrate, nitric oxide, and inhaled iloprost was evaluated on Hemodynamic parameters (mean PAP, PAWP, SVI). Nitric oxide caused left ventricular overload (PAWP increased by 11%) and decreased stroke volume index, whereas isosorbide dinitrate and inhaled iloprost improved these hemodynamic parameters.
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