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PubMed1992

[Clinical and experimental study of the production of renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation].

Renal hemodynamics during IABP-assisted pulsatile flow extracorporeal circulation was assessed in terms of measurement values for intraoperative renal blood flow obtained by the local thermodilution method in human clinical patients. In addition, the effect of IABP on renal hemodynamics was investigated in an animal model of renal denervation in a study undertaken to elucidate the action mechanism of IABP. Eighteen patients with acquired heart disease were involved in the study and measured for the renal blood flow (RBF), cardiac output (CO), renal-systemic partition coefficient for blood flow (RBF/CO), renal vascular resistance (RVR) and perfusion pressure. In the pulsatile flow group, the RBF/CO increased as the number of pump runs increased, whole the RVR was conversely reduced with increasing pump runs. The experimental study without extracorporeal circulation was conducted on 19 mongrel dogs. During IABP runs RBF/CO increased, while the RVR decreased. After renal denervation, no noticeable influence of IABP upon renal hemodynamics was observed. Following a loading dose of noradrenaline (Norad), the RVR increased in a Norad concentration-dependent fashion, independently of IABP and renal denervation. These results indicate that IABP reduces the RVR and thereby exerts a favorable action on renal hemodynamics during pump times. The study thus warrants us to surmise that a mechanism involving the renal sympathetic nerves might play an important role in the production of favorable renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation.

Animals↗
PubMed1992

Dynamic cardiomyoplasty for hemodynamic support during acute pulmonary hypertension. An experimental study.

The efficacy of dynamic cardiomyoplasty for hemodynamic support during acute pulmonary hypertension was studied. Five dogs underwent a right latissimus dorsi cardiomyoplasty. Each dog was later studied in a short-term experiment. A graded acute pulmonary hypertension was induced by infusion of glass microspheres into the pulmonary artery. This resulted in decrease in pulmonary artery flow, systemic pressure, and systemic flow. The cardiomyoplasty was then stimulated with a new R wave synchronous rate-responsive pulse-train stimulator (Prometheus system). This pacemaker delivers a pulse train with the duration of stimulation determined as a proportion of the RR interval. At an optimal level of hemodynamic impairment, the dynamic cardiomyoplasty was able to immediately improve pulmonary artery flow 26.4% +/- 5.84% (standard error of the mean) (p less than 0.005, paired t test), mean systemic arterial pressure 11.6% +/- 3.7% (p less than 0.05), and thoracic aortic flow 15.7% +/- 6.3% (p less than 0.05). The degree of improvement in hemodynamic variables could be correlated with the magnitude of hemodynamic impairment present (e.g., r = 0.78; p less than 0.005 for pulmonary blood flow). We conclude that a significant beneficial effect of dynamic cardiomyoplasty on hemodynamics in short-term canine pulmonary hypertension is demonstrated in this study. Thus cardiomyoplasty may be useful in patients with right heart failure associated with increased pulmonary vascular resistance.

Acute Disease↗
PubMed1992

[Doppler-metric and Doppler echocardiographic study of the nature and stage of disorders of fetal hemodynamics in intrauterine fetal growth retardation].

Pregnancy course, labor outcome, and doppler-metric findings were analyzed in 174 women, 98 with normal pregnancy (controls) and 76 with small-for-date fetuses when examined on weeks 28-41; the aim of the study was to analyze the pattern of hemodynamic disorders in small-for-date fetuses. A classification of fetal hemodynamic disorders has been developed, that distinguishes three types of disorders differing in severity: first degree--disordered fetoplacental circulation not reaching the critical values and satisfactory fetal hemodynamics; second degree--compensated disorders of fetal hemodynamics; third degree--critical state of fetal hemodynamics. Use of this classification in clinical practice will help define rational strategy of pregnancy follow-up.

Echocardiography, Doppler↗
PubMed2005

Hemodynamic adjustments to circulatory arrest during and following isometric handgrip in resistance trained and untrained men.

AIM: We attempted to isolate the effects of central command (CC) and the muscle metaboreflex (MR) on hemodynamics during and following fatiguing isometric handgrip (IHG) with circulatory arrest in 9 male weightlifters (WL) and 11 age-matched controls (C). METHODS: Hemodynamics were recorded at rest, during fatiguing IHG at 40% MVC with occlusion, and during post-IHG occlusion. Blood pressures were measured by auscultation and stroke volume by impedance cardiography. RESULTS: Hemodynamic adjustments due to CC were determined from the difference (fatigue post-IHG occlusion) in measures at fatigue during IHG (CC+MR effects) and during post-IHG occlusion (MR effect). Hemodynamic adjustments due to the MR were determined from the difference (post-IHG occlusion rest) in measures during post-IHG occlusion and at rest. The peak adjustment (due to CC+MR) in systolic blood pressure (44.6+/-12.9 vs 33.8+/-6.2 mmHg, P=0.02) and the adjustments (due to CC) in diastolic (13.8+/-7.6 vs 6.9+/-5.1 mmHg, P=0.02) and mean arterial blood pressures (14.9+/-7.8 vs 8.7+/-4.6 mmHg, P=0.04) were significantly greater in WL than C. However, there were no significant (P>0.05) group differences in hemodynamic adjustments (due to MR) to post-IHG occlusion. CONCLUSION: We conclude that weight training may result in significantly greater CC effects on peak pressor responses to moderately intense, fatiguing isometric actions with circulatory arrest.

Adult↗
PubMedDate not supplied

Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models.

BACKGROUND AND PURPOSE: Hemodynamic factors are thought to play an important role in the initiation, growth, and rupture of cerebral aneurysms. This report describes a pilot clinical study of the association between intra-aneurysmal hemodynamic characteristics from computational fluid dynamic models and the rupture of cerebral aneurysms. METHODS: A total of 62 patient-specific models of cerebral aneurysms were constructed from 3D angiography images. Computational fluid dynamics simulations were performed under pulsatile flow conditions measured on a normal subject. The aneurysms were classified into different categories, depending on the complexity and stability of the flow pattern, the location and size of the flow impingement region, and the size of the inflow jet. The 62 models consisted of 25 ruptured and 34 unruptured aneurysms and 3 cases with unknown histories of hemorrhage. The hemodynamic features were analyzed for associations with history of rupture. RESULTS: A large variety of flow patterns was observed: 72% of ruptured aneurysms had complex or unstable flow patterns, 80% had small impingement regions, and 76% had small jet sizes. By contrast, unruptured aneurysms accounted for 73%, 82%, and 75% of aneurysms with simple stable flow patterns, large impingement regions, and large jet sizes, respectively. Aneurysms with small impingement sizes were 6.3 times more likely to have experienced rupture than those with large impingement sizes (P = .01). CONCLUSIONS: Image-based patient-specific numeric models can be constructed in an efficient manner that allows clinical studies of intra-aneurysmal hemodynamics. A simple flow characterization system was proposed, and interesting trends in the association between hemodynamic features and aneurysmal rupture were found. Simple stable patterns, large impingement regions, and jet sizes were more commonly seen with unruptured aneurysms. By contrast, ruptured aneurysms were more likely to have disturbed flow patterns, small impingement regions, and narrow jets.

Adult↗
PubMed1991

Anesthetic and hemodynamic effects of dexmedetomidine during isoflurane anesthesia in a canine model.

Dexmedetomidine, an alpha 2-adrenergic agonist, was administered during isoflurane anesthesia to investigate its anesthetic sparing and hemodynamic effects in the canine model. Eleven healthy dogs were anesthetized with isoflurane, intubated, and allowed to breathe spontaneously. The animals were instrumented in order to measure or calculate mean arterial blood pressure (MABP), heart rate (HR), left ventricular end diastolic pressure (LVEDP), cardiac output (CO), and systemic vascular resistance (SVR). Isoflurane minimum alveolar concentration (MAC), baseline hemodynamic measurements, and plasma catecholamine levels were determined. A 20 micrograms/kg bolus of dexmedetomidine was injected intravenously (IV) and MAC and hemodynamic values were redetermined. When isoflurane requirements were 33% of baseline, isoflurane was returned to 90% MAC and the alpha 2-antagonist, atipamezole, was administered. All dogs were treated with 40 micrograms/kg glycopyrrolate throughout the experiment to prevent any bradycardic response. Dexmedetomidine reduced isoflurane MAC by 86%. SVR, MABP, and LVEDP were significantly increased while CO and catechloamine levels were reduced. Atipamezole fully reversed the reduction in anesthetic requirements. MABP and catecholamine levels returned to baseline. SVR and LVEDP increased while CO decreased. The dogs exhibited a profound reduction in anesthetic requirement, reduced catecholamine levels, and changes in hemodynamic parameters with dexmedetomidine administration. The anesthetic sparing effect appears to be mediated by the alpha 2-receptor, since atipamezole reversed the reduction in MAC. Hemodynamic changes may be species or dose related, or due to differences in existing sympathetic tone. The role of dexmedetomidine warrants further study as an adjunct anesthetic agent.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

A correlative study of the functional class and hemodynamic status following intracardiac repair of tetralogy of Fallot.

An attempt was made to correlate the NYHA Functional class with the hemodynamic status of 196 patients at an average of 21.2 months following the intracardiac repair of tetralogy of Fallot. 171 patients were in Functional class I (87.2%), 9 in class III (4.5%), 5 in class II (2.5%) and 11 in class IV (5.6%). Right and left heart catheterisation and cardiac angiography revealed the hemodynamic status of these patients to be excellent in 92 (46.4%), good in 37 (18.8%), satisfactory in 6 (3.0%) and unsatisfactory in 61 (31.6%). Whereas all patients in Functional class II, III and IV had unsatisfactory hemodynamic findings, patients in Functional Class I were hemodynamically heterogeneous and included excellent (53.8%), good (21.6%), satisfactory (3.5%) and unsatisfactory (21%) groups. The surgical technique did not seem to determine the functional status. While early reoperation is advisable for patients with functional disability, caution is necessary in considering reoperation for patients in Functional class I who have hemodynamic findings which are classified as unsatisfactory.

Adolescent↗
PubMed1991

Invasive hemodynamic monitoring in pregnancy.

Invasive hemodynamic monitoring is indicated in the critically ill pregnant or postpartum patient, whose hemodynamic state cannot be reliably determined by clinical observation and noninvasive methods. In addition, precise hemodynamic information must be indispensable to determine and monitor treatment. Complications of central hemodynamic monitoring using the Swan-Ganz catheter appear to be rare in experienced hands. To maintain and expand the necessary skills and experience, invasive hemodynamic monitoring should be centralized in obstetric intensive care units.

Blood Pressure↗
PubMed1991

[Hemodynamics as affected by delta-sleep-inducing peptide].

The study was performed on 20 male rabbits. The effect of intravenous delta-sleep-inducing peptide (DSIP), 60 nmol/kg in 5 ml of saline, on central hemodynamic parameters was studied in 11 experiments. Nine rabbits formed the control group. Two heterodirectional responses of the heart and vessels occurred in the animals given DSIP, which made them divide into 2 groups: those with a predominantly cardiac type of hemodynamic responses (n = 5) and animals with a predominantly vascular type of hemodynamic responses (n = 6). The results of the studies showed that DSIP affected central hemodynamics of intact animals; a direct action of DSIP on the vascular tone and permeability as well as on myocardial contractility cannot be excluded. The changes in hemodynamic parameters were, however, within the physiological normal range.

Animals↗
PubMed1991

[Hemodynamic parameters in the evaluation of myocardial oxygen consumption during anesthesia].

Direct measurements of myocardial oxygen consumption (MVO2) and of a number of hemodynamic variables were performed in 60 patients with coronary heart disease undergoing three-vessel coronary artery bypass surgery. Anesthetic procedures included halothane, enflurane, isoflurane, propofol fentanyl, midazolam/fentanyl, and morphine anesthesia. The following hemodynamic variables were correlated with MVO2: systolic pressure (Psyst), mean arterial pressure (Part), heart rate (HR), cardiac index (CI), stroke volume index (SVI) and arithmetic combined variables: Psyst x square root (HR), Part x square root (HR), Psyst x HR, Part x HR, Psyst x HR x ta(ejection time), Part x HR x ta, Psyst x CI, Part x CI. The product of Psyst x square root (HR) is equivalent to the tension/time index as modified by Bretschneider and the product Psyst x HR x ta is equivalent to the tension/time index of Sarnoff as modified by Robinson. Production and uptake of lactate as metabolic equivalents of myocardial oxygenation were also correlated with myocardial oxygen consumption. Measurements were performed with the patients awake, after induction of anesthesia without surgical stimulation, during sternotomy and after the operation. We obtained 209 evaluable measurements (MVO2 vs hemodynamic variables). The single hemodynamic variables that correlated best with MVO2 was systolic pressure (r = 0.67). Stroke volume index (r = 0.1) and heart rate (r = 0.32) were poorly correlated. The combined hemodynamic variables that correlated most closely with MVO2 were the tension/time indices modified by Bretschneider (Psyst x square root (HR)) and Robinson (Psyst x HR x ta) (r = 0.72). Production and consumption of lactate were not correlated with myocardial oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Immunosuppressive drugs for the treatment of active myocarditis in children. Hemodynamic evaluation].

PURPOSE: To analyse hemodynamic parameters (left ventricles ejection fraction, cardiac index, mean pulmonary wedge pressure and left ventricle diastolic diameter, in a group of children with active myocarditis (diagnosed by endomyocardial biopsy) pre and post treatment with conventional therapy and immunosuppressive drugs (isolated prednisone or prednisone associated with azathioprine or cyclosporine). PATIENTS AND METHODS: Forty-four pediatric patients with active myocarditis were studied. Twenty males and 24 females from 10 months to 15 years old (median = 1.3 years). All patients were submitted to hemodynamic study and endomyocardial biopsy. The hemodynamic parameters mentioned above were analysed before and after the proposed therapy. The patients were distributed in group according to the admission in the protocol, group I (9 pts)--conventional therapy (CT); group II (12 pts)--CT plus prednisone; group III (16 pts)--CT plus prednisone plus azathioprine; group IV (13 pts)--CT plus prednisone plus cyclosporine. RESULTS: Forty-four patients were submitted to four different groups of therapeutic protocol. The hemodynamic parameters were analysed in each of them. Left ventricle ejection fraction were no significantly different in the pre and post therapeutic scheme in group I and II, they were significantly higher (p less than 0.05) in group III and IV. The same happened with cardiac index. The mean pulmonary wedge pressure no presented statistical differences in group I and II before and after treatment but significantly lower lends were observed in group III and IV. The same behavior were noted in the left ventricle end diastolic diameter. CONCLUSION: The association of azathioprine or cyclosporine to prednisone presented better results in the left ventricle function, when compared with conventional drugs or isolated use of prednisone, based in the analysis of same hemodynamic parameters.

Adolescent↗
PubMedDate not supplied

[A comparative evaluation of the central hemodynamic indices in patients with the terminal stage of kidney failure during dialysis therapy and allografting].

Changes of the functional indices of central and intracardiac hemodynamics during treatment with hemodialysis or peritoneal dialysis, as well as after cadaver kidney transplantation, were studied in 44 patients with the terminal stage of chronic renal failure by means of radiocardiography with 131I-albumin. The signs of cardiac insufficiency were evaluated according to the classes of the cardiologists' New York classification accepted in 1964. Four groups of patients were distinguished during the analysis: group 1-10 patients given intravenous detoxification therapy; group 2-19 patients treated by chronic programmed hemodialysis; group 3-4 patients kept on peritoneal dialysis; group 4-11 patients after allotransplantation of cadaver kidney. It was found that in group 1 patients the indices of central (mean arterial pressure, cardiac and stroke indices, total peripheral vascular resistance, work of the left ventricle) and intracardiac (time of circulation of blood in the heart cavities and lungs) hemodynamics were on the upper normal values and in occasional cases exceeded it. In patients of group 2 the indices of intracardiac hemodynamics grew worse and required an individual approach to the hemodialysis regimens with due account for the volemic disorders. In group 3 some indices of central and intracardiac hemodynamics corresponded to those in group 2, but the circulation volume, and mean arterial pressure were normal, which was reflected by better subjective tolerance to peritoneal dialysis. Analysis of indices in group 4 patients showed improvement of normalization of most parameters of central and intracardiac hemodynamics with gradual increase of diuresis, and abatement of the clinical signs of cardiac insufficiency after successful transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1990

[Effects of mildronate (quaterin) on hemodynamics in spontaneous and artificial heart rhythm in patients with ischemic heart disease].

Central hemodynamic parameters under the effect of mildronate were examined in 62 patients suffering from coronary heart disease, 35 of these with acute myocardial infarction complicated by acute left-ventricular insufficiency and 20 with atherosclerotic cardiosclerosis with chronic cardiac insufficiency. The drug effect was assessed in two groups of patients after a single intravenous injection of 0.5-3 g. In group 1 (n = 53) mildronate effect on central hemodynamic parameters was assessed in spontaneous cardiac rhythm. Variously directed statistically unreliable hemodynamic shifts were revealed, related to heart rhythm changes. In group 2 (n = 9) the drug effect on heart rhythm was eliminated with the use of two-chamber electrocardiostimulation, and various hemodynamic regimens with hypo-, eu-, and hyperkinetic circulation types were artificially created by changing the A-V interval. Mildronate had no effect on the hemodynamics during two-chamber electrocardiostimulation.

Adult↗
PubMed1990

[Senile alteration of hemodynamics in surgery of abdominal aneurysm].

Hemodynamic measurements were performed before, during and after surgery of aneurysmal patients. Fifty non-ruptured infrarenal aneurysmal patients undergoing elective aortic reconstructions were studied. Patients who had no evidence of heart disease were divided into two groups by age. The older group consisted of 22 patients older than 70 years of age, and the younger group consisted of 28 patients younger than 70 years. The results may be summarized as follows: (1) Hemodynamics before surgery (volume loaded test): For 500 ml albumin infusion within 30 minutes, cardiac indices of the older group kept below 4.0 l/min/m2, whereas in the younger group there was an increase from 3.66 to 4.42 l/min/m2. (2) Hemodynamics during surgery: Peripheral resistance increased by cross-clamping of the aorta, and decreased after removal of the aorta, and decreased after removal of the cross clamp in both groups. Cardiac indices dropped during cross-clamping of the aorta. The older group dropped more noticeably compared with the younger group, for instance, at one minute after cross-clamping, the older group was 2.04 +/- 0.56, and the younger group was 2.44 +/- 0.56 l/min/m2. Mean pulmonary wedge pressure increased gradually during surgery in both groups. (3) Hemodynamics after surgery: The older group kept lower cardiac indices compared with the younger group, but not so noticeably. These results indicated that older patients have low cardiac function for preload and afterload change. We will be confronted by an increasing number of older patients in the near future. Hemodynamic managements of aortic reconstructions in the elderly might become important.

Age Factors↗
PubMed1989

[Hemodynamic effects of the intravenous administration of captopril in patients with chronic congestive heart failure].

The aim of the present study was to evaluate the hemodynamic response to the intravenous administration of the angiotensin converting enzyme-inhibitor captopril. Plasmatic renin activity was also monitored. The study population included 10 patients with chronic congestive heart failure: 3 were in the second NYHA functional class, 5 in the third, and 2 in the fourth. The patients received a first dose of 5 mg of captopril followed, after 10 min, by a second bolus-dose of 15 mg. Hemodynamic and hormonal measurements were repeated in the following 4 hours. The greatest hemodynamic effect, considered as the time of maximal mean arterial pressure and systemic vascular resistances decrease, and cardiac index increase, was noted 20 min after the first bolus dose administration. Mean arterial pressure (MAP) decreased by 13% (p less than 0.01), mean pulmonary artery pressure (MPAP) by 14% (p less than 0.05), right atrial pressure (RAP) by 30% (NS), wedge pressure (WPP) by 23% (p less than 0.01), systemic vascular resistances (SVR) by 21% (p less than 0.05), pulmonary vascular resistances by 22% (NS); cardiac index (CI) increased by 12% (p less than 0.05), stroke volume index by 10% (NS). Heart rate didn't change. The plasmatic renin activity (PRA) increased by 339% (p less than 0.01) reaching the maximal level in concomitance with the greatest hemodynamic effect. Hemodynamic changes were already noted 5 min after the first dose and lasted up to 75 min later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Hemodynamic and clinical effects of captopril in patients with severe congestive heart failure.

In a group of 10 patients (9 male, 1 female, aged 16 to 56, mean 43 years) with severe congestive heart failure (CHF), due to ischemic heart disease (8 cases) or dilatative cardiomyopathy (2 cases), the acute hemodynamic response to captopril (CPT) (90 min after 50 mg po) was evaluated. CPT was then given starting with 15 mg q 8 hr, gradually increased within 2 or 3 days to 50 or 75 mg q 8 hr. A hemodynamic re-evaluation was performed after 20 days, and, in 5 patients, after 1 year of CPT treatment. The clinical follow-up done every 3 months in the outpatient clinic. CPT acutely produced a decrease in mean pulmonary wedge pressure: 23.8 +/- 8.9 to 18.6 +/- 8.6 mmHg, p less than 0.01, and an increase in cardiac index: 2.43 +/- 0.73 to 2.91 +/- 0.85 l/min/m2, p less than 0.01; systemic and pulmonary resistances decreased significantly, with no significant changes in heart rate and in mean brachial artery pressure. This favourable hemodynamic response persisted after 20 days of CPT treatment. In the group of 5 patients, who underwent a third hemodynamic evaluation, no statistically significant differences were demonstrated in respect to the previous control values. All patients on chronic CPT treatment experienced a gradual clinical improvement, reaching a steady state after 2 to 3 weeks; the surviving patients remained stable in the improved functional class for at least 6 months. The mortality rate was 30% in the first year, increasing to 50% in the second and to 60% in the third year of treatment. After a mean follow-up 35.7 months (range 33 to 39) the 4 surviving patients remained in the same functional class as after the first year for therapy. In our CHF patients CPT improved the quality of life, with the best clinical and hemodynamic results the first few months of treatment; life expectancy probably was not affected.

Adolescent↗
PubMed1989

[Changes in central hemodynamics and gas exchange after a single and scheduled administration of obsidan in patients with exertion-induced stenocardia and various types of blood circulation].

Sixty-two patients with angina of effort and different circulation types were investigated to assess the pattern of changes in hemodynamics and gas exchange following an acute obsidan test and a course of obsidan treatment. A relationship was demonstrated between the effect of obsidan on central hemodynamics and gas exchange, on the one hand, and the baseline circulatory type, on the other. In patients with hyper- and eukinetic circulation, the drug increased the maximum oxygen uptake and total performance volume in the presence of a variety of hemodynamic changes; such as the negative inotropic and chronotropic effects in the hyperkinetic-type patients, and the negative chronotropic effect in the eukinetic-type ones. In hypokinetic-type patients, the drug had no effect on hemodynamics. The lack of changes in physical working capacity parameters was due to a shift in the conditions of stress exposure towards anaerobic metabolism. A correlation was demonstrated between changes in some hemodynamic and gas exchange parameters following both a single dose and a treatment course of obsidan.

Adult↗
PubMed1989

[Hemodynamic effect of isosorbide-5-mononitrate in acute cardiac insufficiency secondary to myocardial infarct].

The hemodynamic effects of IS-5-MN were studied in 18 patients with acute myocardial infarction (AMI) complicated with left ventricular failure. Before treatment, 13 patients were in Forrester's hemodynamic class II and 5 in class IV. Hemodynamic monitoring was performed for 3 days, and the following parameters were measured: heart rate (HR), blood pressures (BP), right atrial (RAP), pulmonary artery and pulmonary capillary (PCP) pressures, cardiac index (CI), systemic (SVR) and pulmonary (PVR) vascular resistances, and coronary perfusion pressure (CPP). Patients with clinical symptoms of acute pulmonary edema or systolic BP (BPs) less than 90 mmHg were not included. Twenty mg of 5-IS-MN per os were administered every 8 h. Hemodynamic measurements and IS-5-MN plasma levels were obtained in basal conditions and 1/2, 1, 2, 6 and 8 h after the first and seventh dose of IS-5-MN. A significant decrease of systolic and diastolic BPs, RAP, PCP, SVR and PVR was observed after 1/2 of IS-5-MN administration and was maintained through the study, while CI and CPP increased and HR remained unchanged. The hemodynamic effect was maintained after the seventh dose, with a further decrease of the following parameters: BP, RAC, PCP and PVR. However, 2 patients were withdrawn from the study due to severe symptoms of heart failure. One patient presented headache. IS-5-MN plasma levels were identified after 1/2 h, with a peak level after 1 h, and were similar after the seventh dose. A significant correlation was found between the IS-5-MN levels and the delta RAP and delta PCP after the seventh dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗