Effects of Vasodilator Drugs on the Pulmonary Circulation

Introduction: In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.. Materials and methods: We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome. Results: We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation. Conclusions: We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

Download Full-text

Arterial Duct Stenting in Congenital Heart Disease with Duct-Dependent Pulmonary Circulation

Current Pediatric Reviews ◽

10.2174/157339610793743930 ◽

2010 ◽

Vol 6 (3) ◽

pp. 183-191

Author(s):

Giuseppe Santoro ◽

Biagio Castaldi ◽

Gianpiero Gaio ◽

Maria Teresa Palladino ◽

Carola Iacono ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pulmonary Circulation ◽

Congenital Heart ◽

Arterial Duct

Download Full-text

Role of the Pulmonary Circulation in the Distribution of Human Fetal Cardiac Output During the Second Half of Pregnancy

Circulation ◽

10.1161/01.cir.94.5.1068 ◽

1996 ◽

Vol 94 (5) ◽

pp. 1068-1073 ◽

Cited By ~ 204

Author(s):

Juha Rasanen ◽

Dennis C. Wood ◽

Stuart Weiner ◽

Abraham Ludomirski ◽

James C. Huhta

Keyword(s):

Cardiac Output ◽

Pulmonary Circulation

Download Full-text

Carbon Monoxide and Pulmonary Circulation in an Ovine Model

Journal of Burn Care & Rehabilitation ◽

10.1097/00004630-199211000-00003 ◽

1992 ◽

Vol 13 (6) ◽

pp. 623-627 ◽

Cited By ~ 2

Author(s):

J. L. Theissen ◽

H. M. Loick ◽

L. D. Traber ◽

D. N. Herndon ◽

D. L. Traber

Keyword(s):

Carbon Monoxide ◽

Pulmonary Circulation ◽

Ovine Model

Download Full-text

Oxygen-Sensitivity and Pulmonary Selectivity of Vasodilators as Potential Drugs for Pulmonary Hypertension

Antioxidants ◽

10.3390/antiox10020155 ◽

2021 ◽

Vol 10 (2) ◽

pp. 155

Author(s):

Daniel Morales-Cano ◽

Bianca Barreira ◽

Beatriz De Olaiz Navarro ◽

María Callejo ◽

Gema Mondejar-Parreño ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Gas Exchange ◽

Pulmonary Circulation ◽

Pulmonary Arteries ◽

Blood Perfusion ◽

Mesenteric Arteries ◽

Oxygen Sensitivity ◽

Low Oxygen ◽

Oxygen Selectivity

Current approved therapies for pulmonary hypertension (PH) aim to restore the balance between endothelial mediators in the pulmonary circulation. These drugs may exert vasodilator effects on poorly oxygenated vessels. This may lead to the derivation of blood perfusion towards low ventilated alveoli, i.e., producing ventilation-perfusion mismatch, with detrimental effects on gas exchange. The aim of this study is to analyze the oxygen-sensitivity in vitro of 25 drugs currently used or potentially useful for PH. Additionally, the study analyses the effectiveness of these vasodilators in the pulmonary vs. the systemic vessels. Vasodilator responses were recorded in pulmonary arteries (PA) and mesenteric arteries (MA) from rats and in human PA in a wire myograph under different oxygen concentrations. None of the studied drugs showed oxygen selectivity, being equally or more effective as vasodilators under conditions of low oxygen as compared to high oxygen levels. The drugs studied showed low pulmonary selectivity, being equally or more effective as vasodilators in systemic than in PA. A similar behavior was observed for the members within each drug family. In conclusion, none of the drugs showed optimal vasodilator profile, which may limit their therapeutic efficacy in PH.

Download Full-text

Mid-Term Outcomes After Unifocalization Guided by Intraoperative Pulmonary Flow Study

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120964427 ◽

2021 ◽

Vol 12 (1) ◽

pp. 76-83

Author(s):

Ariana Goodman ◽

Michael Ma ◽

Yulin Zhang ◽

Kathleen R. Ryan ◽

Ozzie Jahadi ◽

...

Keyword(s):

Pulmonary Circulation ◽

Septal Defect ◽

Pressure Ratio ◽

Major Aortopulmonary Collateral Arteries ◽

Intracardiac Repair ◽

Pulmonary Flow ◽

Collateral Arteries ◽

Complete Repair ◽

The Relationship ◽

Flow Study

Background: Repair of tetralogy of Fallot (TOF) with major aortopulmonary collateral arteries (MAPCAs) requires unifocalization of pulmonary circulation, intracardiac repair with the closure of the ventricular septal defect, and placement of a right ventricle (RV) to pulmonary artery (PA) conduit. The decision to perform complete repair is sometimes aided by an intraoperative flow study to estimate the total resistance of the reconstructed pulmonary circulation. Methods: We reviewed patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs to evaluate acute and mid-term outcomes after repair with and without flow studies and to characterize the relationship between PA pressure during the flow study and postrepair RV pressure. Results: Among 579 patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs, 99 (17%) had an intraoperative flow study during one (n = 91) or more (n = 8) operations to determine the suitability for a complete repair. There was a reasonably good correlation between mean PA pressure at 3 L/min/m2 during the flow study and postrepair RV pressure and RV:aortic pressure ratio. Acute and mid-term outcomes (median: 3.8 years) after complete repair in the flow study patients (n = 78) did not differ significantly from those in whom the flow study was not performed (n = 444). Furthermore, prior failed flow study was not associated with differences in outcome after subsequent intracardiac repair. Conclusions: The intraoperative flow study remains a useful adjunct for determining the suitability for complete repair in a subset of patients undergoing surgery for TOF/MAPCAs, as it is reasonably accurate for estimating postoperative PA pressure and serves as a reliable guide for the feasibility of single-stage complete repair.

Download Full-text