ABSTRACT
Prostaglandin E1. (Prostavasin, Schwarz, FRG) was administered in a short-term infusion, 5-30 ng/kg/min., to five patients with precapillary pulmonary hypertension associated with lung disease. Significant pulmonary vasodilatation characterized by a drop of the median pressure in the pulmonary artery by 15% and of the pulmonary vascular resistance by 31% was achieved only in two patients. The authors observed a minimal incidence of side-effects; systemic hypotension observed in three patients was an undesirable manifestaútion. Prostaglandin E1 extends possibilities of a vasodilatating influence on precapillary pulmonary hypertension in lung disease. With regard to the different individual reactivity of patients it should be administered in this indication only under conditions of haemodynamic monitoring.
Subject(s)
Alprostadil/therapeutic use , Hypertension, Pulmonary/physiopathology , Lung/blood supply , Vasodilation/drug effects , Adult , Aged , Alprostadil/administration & dosage , Blood Pressure/drug effects , Female , Humans , Hypertension, Pulmonary/drug therapy , Male , Middle Aged , Pulse/drug effects , Respiratory Mechanics/drug effects , Vascular Resistance/drug effectsABSTRACT
The magnitude of a left-to-right shunt in atrial septal defects was evaluated independently in catheterizations of the heart according to saturations and characteristics of the shunt stream in colour-flow Doppler echocardiography. The ratio of the pulmonary and systemic flow (Qp/Qs) assessed in 14 patients with atrial septal defects during catheterization correlated significantly with the maximal breadth (r = 0.8; p less than 0.001) and maximum area (r = 0.78; p less than 0.01) of the visualized shunted stream in transthoracic colour-flow Doppler echocardiography. Examination by means of transoesophageal colour-flow Doppler echocardiography in 8 patients revealed a correlation only with the maximal breadth of the shunted stream (r = 0.95; p less than 0.001). The magnitude of the maximum area of the shunted stream in transthoracic colour-flow Doppler echocardiography made it only possible to differentiate patients with a significant and not significant left-to-right shunt, i.e. Qp/Qs greater or smaller than 1.5:1. All patients with a shunt greater than 1.5:1 had a maximal area of the shunted stream greater than 10 sq.cm or 6 sq.cm/sq.m resp. Colour-flow Doppler echocardiography is a suitable method for the semiquantitative evaluation of the haemodynamic significance of atrial septal defects in adult patients.
Subject(s)
Echocardiography, Doppler , Heart Septal Defects, Atrial/diagnosis , Adolescent , Adult , Female , Humans , Male , Middle AgedSubject(s)
Mitral Valve Stenosis/physiopathology , Physical Exertion , Pulmonary Wedge Pressure , Adult , Female , Humans , Male , Middle Aged , Mitral Valve Stenosis/surgerySubject(s)
Pericardiectomy , Pericarditis, Constrictive/surgery , Adult , Aged , Chronic Disease , Female , Follow-Up Studies , Hemodynamics , Humans , Male , Middle Aged , Pericarditis, Constrictive/physiopathologySubject(s)
Mitral Valve Insufficiency/etiology , Mitral Valve/abnormalities , Adult , Female , HumansSubject(s)
Exercise Test , Heart Valve Diseases/classification , Adult , Female , Heart Valve Diseases/physiopathology , Humans , Male , Middle AgedABSTRACT
1. Po2, Pco2 and pH were examined in twenty-seven pulmonary "wedge" samples of blood obtained from seventeen patients with various heart diseases. 2. High Po2 and pH, and low Pco2, values were found in comparison with those in simultaneous samples of peripheral arterial blood. In the pulmonary "wedge" samples of blood, the following mean values were found: Po2, 17.65 kPa (132.2 mmHg); Pco2, 3.10 kPa (23.2 mmHg); pH 7.47. An explanation of these findings is considered.
