CONTINUOUS, LOW DOSE OF HYDRALAZINE, REDUCES ACUTE HYPOXIC PULMONARY HYPERTENSION WITHOUT A CORRESPONDING FALL IN SYSTEMIC ARTERIAL PRESSURE
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概要
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Administration of hydralazine in patients with pulmonary hypertension has been reported to cause excessive systemic vasodilatation, limiting its clinical utility (N Engl J Med 1982 ; 306 : 1326). We studied the effects of hydralazine on hypoxic pulmonary vasoconstriction (HPV) in chronically instrumented sheep and evaluated whether different methods of intravenous administration could prevent severe systemic hypotension. Mean left atrial, pulmonary and systemic arterial pressures (Pla, Ppa and Psa mmHg), cardiac output (CO, 1/min, electromagnetic flowmeter) and heart rate were measured continuously. Systemic (SVR) and pulmonary vascular resistances (PVR) were calculated by Psa/CO and (Ppa-Pla)/CO, respectively. Following a 30 min baseline period, we initiated hypoxia with mixture of 10% oxygen in nitrogen. After 20 min of hypoxia we then performed the following two experiments ; Group A-Hydralazine (10 μg/kg/min) was infused continuously for a further 20 min of hypoxia (n=6) ; Group B-Hydralazine (400 μg/kg) was administered as a single bolus, followed by an additional 20 min of hypoxia (n=6). In both Groups A and B, hypoxia produced a prominent pulmonary hypertensive response. Continuous infusion of hydralazine (Group A) significantly decreased the hypoxic values of Ppa and PVR from 25.1 ± 1.1 to 21.7 ± 1.6 mmHg (p < 0.01) and from 4.82 ± 0.50 to 4.17 ± 0.40 mmHg/1/min (p < 0.05), respectively. In Group B, hydralazine as a bolus also significantly decreased HPV, with Ppa dropping from 20.9 ± 0.9 to 18.3 ± 1.5 mmHg (p < 0.05) and PVR falling from 4.98 ± 0.55 to 4.34 ± 0.53 mmHg/1/min (p < 0.05). The magnitude of the decrease in Ppa and PVR was similar in both groups. A significant decreases in Psa in the first 5 min after hydralazine infusion was observed n Group B but not in Group A. These findings suggest that hydralazine reduces PV in conscious sheep, and that continuous infusion of a low dose of hydralazine can inhibit the HPV without a marked fall in systemic arterial pressure.
- 社団法人日本循環器学会の論文
- 1986-10-20
著者
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KOBAYASHI Toshio
Department of Physics, Tohoku University
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Yoshimura Kazuhiko
Departments of Internal Medicine and Adaptation Physiology, Shishu University School of Medicine
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Yoshimura Kazuhiko
Department Of Internal Medicine Omachi City General Hospital
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Yoshimura Kazuhiko
Department Of Internal Medicine Shinshu University School Of Medicine
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Kobayashi Toshio
Department Of Internal Medicine Tokai University Oiso Hospital
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Kobayashi Toshio
Department Of Hygiene And Preventive Medicine Fukushima Medical University School Of Medicine
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