Document Detail


Hemodynamic effects of urapidil in patients with pulmonary hypertension. A comparative study with hydralazine.
MedLine Citation:
PMID:  3813189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vasodilator therapy for pulmonary hypertension ideally should cause a proportionately greater reduction of resistance in the pulmonary vascular bed than in the systemic circulation. This should limit the occurrence of systemic hypotension, which can complicate the use of most vasodilator drugs. Urapidil is a new vasodilator that acts by postsynaptic alpha 1-blockade while inhibiting the aortic pressure baroreceptor reflex and reducing central sympathetic tone. We investigated and compared the short-term effects of Urapidil and hydralazine in 10 patients suffering varying degrees of pulmonary hypertension. Each patient received either 0.35 mg/kg hydralazine or 0.75 mg/kg Urapidil intravenously on 2 sequential days in a randomized order. The main effect of Urapidil was to decrease the mean pulmonary artery pressure in all 10 patients from 44 +/- 4 to 37 +/- 3.5 mm Hg (p less than 0.001). After Urapidil infusion, the mean decrease of resistance in the pulmonary vascular bed (32%) exceeded that in the systemic circulation (25%). In contrast, pulmonary artery pressure remained unchanged with hydralazine, and predominant systemic vasodilation occurred: systemic vascular resistance decreased by 45%, whereas pulmonary vascular resistance decreased by 25%. Hydralazine markedly increased the cardiac index and induced tachycardia. Urapidil maintained the heart rate nearly constant and only slightly increased the cardiac index, thereby fostering the diastolic emptying of the pulmonary circulation. No significant change in arterial oxygenation occurred with either drug, although arterial oxygen partial pressure tended to increase with hydralazine. Urapidil may be a promising drug in the treatment of patients with pulmonary hypertension.
Authors:
S Adnot; C Defouilloy; C Brun-Buisson; F Abrouk; J Piquet; F Lemaire
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  135     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-11     Completed Date:  1987-03-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  288-93     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / drug effects
Cardiac Output / drug effects
Female
Hemodynamics / drug effects*
Humans
Hydralazine / therapeutic use*
Hypertension, Pulmonary / drug therapy*,  physiopathology
Male
Middle Aged
Piperazines / therapeutic use*
Pulmonary Artery / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Piperazines; 34661-75-1/urapidil; 86-54-4/Hydralazine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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