| High-dose enoximone to evaluate reversibility of pulmonary hypertension: is there a diagnostic value of neurohormonal measurements? | |
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MedLine Citation:
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PMID: 10220638 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Heart transplantation is associated with a reduction of the neurohumoral activation seen in patients with severe congestive heart failure. In this study, we investigated whether pharmacologically induced complex hemodynamic improvement during assessment of reversibility of pulmonary hypertension with a phosphodiesterase inhibitor is able to induce neurohormonal changes of diagnostic importance. METHODS AND RESULTS: Twenty-one patients with New York Heart Association class III-IV heart failure underwent infusion of 3 mg/kg enoximone over a period of 30 minutes. Before and after drug infusion, we determined the plasma concentrations of atrial natriuretic peptide, endothelin-I, angiotensin-II, aldosterone, norepinephrine, epinephrine, and angiotensin-converting enzyme activity sampled from a peripheral vein and the pulmonary artery. In addition to the expected significant reduction of pulmonary hypertension and enhancement of cardiac output, increased levels of the vasoconstrictors endothelin-I, angiotensin-II, and norepinephrine were observed. Aldosterone fell after enoximone infusion; a higher baseline aldosterone level correlated to the degree of reduction of the pulmonary arteriolar resistance by enoximone. Baseline atrial natriuretic peptide levels correlated with parameters, indicating the severity of heart failure. However, the plasma concentration of this peptide did not change significantly after enoximone infusion. CONCLUSIONS: Acute hemodynamic improvement after enoximone bolus in candidates for heart transplantation is not accompanied by a reduction of the enhanced neurohumoral activity in these patients. The reaction of the investigated hormones cannot predict the individual degree of reversibility of pulmonary hypertension. |
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Authors:
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O Schulz; V Mitrovic; M Schönburg; J Thormann |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American heart journal Volume: 137 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1999 May |
Date Detail:
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Created Date: 1999-06-04 Completed Date: 1999-06-04 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 887-94 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology and Cardiosurgery, Kerckhoff-Clinic, Max Planck Society, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin II
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blood Atrial Natriuretic Factor / blood* Biological Markers / blood Catecholamines / blood Endothelin-1 / blood Enoximone / administration & dosage* Female Heart Catheterization Heart Failure / blood, complications, drug therapy Hemodynamics / drug effects Humans Hypertension, Pulmonary / blood*, drug therapy, etiology Infusions, Intravenous Male Middle Aged Peptidyl-Dipeptidase A / blood Phosphodiesterase Inhibitors / administration & dosage* Prognosis Pulmonary Artery Pulmonary Veins Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Catecholamines; 0/Endothelin-1; 0/Phosphodiesterase Inhibitors; 11128-99-7/Angiotensin II; 77671-31-9/Enoximone; 85637-73-6/Atrial Natriuretic Factor; EC 3.4.15.1/Peptidyl-Dipeptidase A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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