R. Nagano et al., PREDICTION OF THE CHANGES IN CARDIAC-OUTPUT IN ASSOCIATION WITH PRELOAD REDUCTION THERAPY IN PATIENTS WITH HYPERTENSIVE HEART-FAILURE, Cardiovascular drugs and therapy, 11(1), 1997, pp. 49-56
Citations number
29
Categorie Soggetti
Pharmacology & Pharmacy","Cardiac & Cardiovascular System
In treating patients with acute hypertensive heart failure we often tr
y preload-reduction therapy using diuretics or vasodilators, but this
may frequently produce a considerable decrease in cardiac output, part
icularly in hypertensive patients with diastolic dysfunction. Therefor
e, it is important from the clinical standpoint to predict the change
in cardiac output following preload-reduction therapy. The objective o
f this study was to assess whether the change in cardiac output in ass
ociation with preload-reduction therapy is predictable before treatmen
t by analysis of mitral flow velocity patterns in patients with hypert
ensive heart failure. Changes in left ventricular volumes and cardiac
output in association with preload-reduction therapy and Doppler echoc
ardiographic parameters of the mitral flow velocity pattern before tre
atment were studied in 18 patients with hypertensive heart failure. Ca
rdiac output increased in six patients with systolic dysfunction (frac
tional shortening <25%). In the other 12 patients (those with normal s
ystolic function), the changes in cardiac output were homogenous among
the patients. In this subset there was a greater decrease in cardiac
output in patients with a shorter deceleration time. Thus, analysis of
deceleration time of the early diastolic filling wave before treatmen
t may be useful in estimating the change in cardiac output following p
reload reduction in patients with hypertensive heart failure due to di
astolic dysfunction.