Effect of NO donors on LV diastolic function in patients with severe pressure-overload hypertrophy

Détails

ID Serval
serval:BIB_94E4C4848ED1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Effect of NO donors on LV diastolic function in patients with severe pressure-overload hypertrophy
Périodique
Circulation
Auteur(s)
Matter  C. M., Mandinov  L., Kaufmann  P. A., Vassalli  G., Jiang  Z., Hess  O. M.
ISSN
1524-4539 (Electronic)
Statut éditorial
Publié
Date de publication
05/1999
Volume
99
Numéro
18
Pages
2396-401
Notes
Clinical Trial
Journal Article --- Old month value: May 11
Résumé
BACKGROUND: Previous experimental studies have shown that nitric oxide (NO) modulates cardiac function by an abbreviation of systolic contraction and an enhancement of diastolic relaxation. However, the response to NO donors of patients with severe pressure-overload hypertrophy and diastolic dysfunction is unknown. METHODS AND RESULTS: Intracoronary NO donors were given to 17 patients with severe aortic stenosis. A dose-response curve was obtained with nitroglycerin (30, 90, and 150 microg) in 11 patients and sodium nitroprusside (1, 2, and 4 microg/min) in 6. Left ventricular (LV) high-fidelity pressure measurements with simultaneous LV angiograms were performed at baseline and after the maximal dose of NO. The dose-response curve for intracoronary NO donors showed a marked fall in LV end-diastolic pressure, from 23 to 14 mm Hg (-39%; P<0.0001), whereas LV peak systolic pressure fell only slightly, from 206 to 196 mm Hg (-4%; P<0.01). End-diastolic chamber stiffness decreased from 0.12 to 0.07 mm Hg/mL (P<0.0001) and end-systolic stiffness from 1.6 to 1.3 mm Hg/mL (P<0.01). Heart rate, right atrial pressure, LV ejection fraction, the time constant of isovolumic pressure decay (tau), and LV filling rates remained unchanged. CONCLUSIONS: In patients with severe pressure-overload hypertrophy, intracoronary NO donors exert a marked decrease in LV end-diastolic pressure without affecting LV systolic pump function. Thus, the hypertrophied myocardium appears to be particularly susceptible to NO donors, with a marked improvement in diastolic function.
Mots-clé
Adult Aged Aortic Valve Stenosis/*complications Coronary Angiography Coronary Circulation/drug effects Diastole/*drug effects Dose-Response Relationship, Drug Female Heart Catheterization Hemodynamic Processes Humans Hypertrophy, Left Ventricular/*drug therapy/physiopathology Infusions, Intra-Arterial Male Middle Aged Myocardial Contraction/drug effects Nitric Oxide/*physiology Nitric Oxide Donors/administration & dosage/*therapeutic use Nitroglycerin/administration & dosage/*therapeutic use Nitroprusside/administration & dosage/*therapeutic use Systole/drug effects Ventricular Function, Left/*drug effects Ventricular Pressure
Pubmed
Web of science
Création de la notice
28/01/2008 11:32
Dernière modification de la notice
03/03/2018 19:38
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