Effets hémodynamiques d'un inhibiteur de l'effet vasculaire de la vasopressine chez des patients avec insuffisance cardiaque congestive [Hemodynamic effects of an inhibitor of the vascular effects of vasopressin in patients with congestive heart failure]

Details

Serval ID
serval:BIB_1DF54EB3A333
Type
Article: article from journal or magazin.
Collection
Publications
Title
Effets hémodynamiques d'un inhibiteur de l'effet vasculaire de la vasopressine chez des patients avec insuffisance cardiaque congestive [Hemodynamic effects of an inhibitor of the vascular effects of vasopressin in patients with congestive heart failure]
Journal
Schweizerische medizinische Wochenschrift
Author(s)
Nicod P., Goy J., Waeber B., Bussien J.P., Turini G.A., Nussberger J., Hofbauer K.G., Brunner H.R.
ISSN
0036-7672
Publication state
Published
Issued date
1985
Peer-reviewed
Oui
Volume
115
Number
50
Pages
1823-5
Language
french
Notes
Publication types: English Abstract ; Journal Article - Publication Status: ppublish
Abstract
To assess the role of vasopressin (AVP) in congestive heart failure (CHF), we investigated 10 patients with CHF refractory to conventional treatment, before and 60 minutes after intravenous administration of 5 micrograms/kg of d(CH2)5Tyr(Me)AVP, a specific antagonist of AVP at the vascular receptor level. Heart rate, systemic arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index by thermodilution, and cutaneous blood flow by laser-Doppler technique were measured. In 9 patients there was no significant hemodynamic and cutaneous blood flow response to the AVP antagonist. Plasma AVP was 2.3 +/- 0.8 pg/ml and plasma osmolality 284 +/- 14 mosm/kg H2O. The tenth patient had the most severe CHF. His plasma AVP was 55 pg/ml and plasma osmolality 290 mosm/kg. He responded to the AVP antagonist with a marked decrease in systemic arterial pressure from 115/61 to 79/41 mm Hg, in pulmonary arterial pressure from 58/31 to 33/13 mm Hg and in pulmonary capillary wedge pressure from 28 to 15 mm Hg. Simultaneously cardiac index increased from 1.1 to 2.21 X min-1 X m-2 and cutaneous blood flow rose 5-fold. Thus, most patients with CHF have only moderately elevated plasma AVP and its role in determining peripheral vascular resistance appears to be limited. AVP may become important in rare patients presenting with marked hemodynamic instability and very high plasma AVP.
Keywords
Adult, Arginine Vasopressin, Female, Heart Failure, Hemodynamics, Humans, Male, Osmolar Concentration, Vasopressins
Pubmed
Web of science
Create date
25/01/2008 15:00
Last modification date
20/08/2019 13:54
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