Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction

Evan Loh, Jonathon S. Stamler, Joshua Hare, Joseph Loscalzo, Wilson S. Colucci

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

Background: Pulmonary vascular resistance (PVR) is frequently elevated in patients with advanced heart failure. Nitric oxide (NO), which contributes to the activity of endothelium-derived relaxing factor, causes relaxation of pulmonary arteries and veins in vitro. Inhalation of NO gas causes pulmonary vasodilation in patients with primary and secondary forms of pulmonary hypertension. Methods and Results: To test the hypothesis that inhalation of NO gas lowers PVR in patients with heart failure, we studied the hemodynamic effects of a 10-minute inhalation of NO (80 ppm) in 19 patients with New York Heart Association class III (n=5) and class IV (n=14) heart failure due to left ventricular (LV) dysfunction. Although inhalation of NO had no effect on pulmonary artery pressures, the PVR decreased by 31±7% (P<.001) due to a 23±7% increase (P<.001) in pulmonary artery wedge pressure and despite a (P<.05) decrease in cardiac index. The magnitude of the decrease in PVR with inhaled NO was inversely related (r=-.713; P<.001) to the baseline PVR. Inhaled NO had no effect on heart rate, systemic arterial pressure, systemic vascular resistance, or LV peak +dP/dt or -dP/dt. Conclusions: In patients with heart failure due to LV dysfunction, inhalation of NO causes a decrease in the PVR associated with an increase in LV filling pressure. These findings predict that inhaled NO, if used alone at this dose (80 ppm), may have adverse effects in patients with LV failure.

Original languageEnglish
Pages (from-to)2780-2785
Number of pages6
JournalCirculation
Volume90
Issue number6
StatePublished - Dec 1 1994
Externally publishedYes

Fingerprint

Left Ventricular Dysfunction
Nitric Oxide
Vascular Resistance
Inhalation
Heart Failure
Pulmonary Artery
Gases
Endothelium-Dependent Relaxing Factors
Pulmonary Wedge Pressure
Pulmonary Veins
Ventricular Pressure
Pulmonary Hypertension
Vasodilation
Arterial Pressure
Heart Rate
Hemodynamics
Pressure
Lung

Keywords

  • endothelium-derived factors
  • heart failure
  • lung
  • nitric oxide

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Loh, E., Stamler, J. S., Hare, J., Loscalzo, J., & Colucci, W. S. (1994). Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation, 90(6), 2780-2785.

Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. / Loh, Evan; Stamler, Jonathon S.; Hare, Joshua; Loscalzo, Joseph; Colucci, Wilson S.

In: Circulation, Vol. 90, No. 6, 01.12.1994, p. 2780-2785.

Research output: Contribution to journalArticle

Loh, E, Stamler, JS, Hare, J, Loscalzo, J & Colucci, WS 1994, 'Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction', Circulation, vol. 90, no. 6, pp. 2780-2785.
Loh E, Stamler JS, Hare J, Loscalzo J, Colucci WS. Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation. 1994 Dec 1;90(6):2780-2785.
Loh, Evan ; Stamler, Jonathon S. ; Hare, Joshua ; Loscalzo, Joseph ; Colucci, Wilson S. / Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. In: Circulation. 1994 ; Vol. 90, No. 6. pp. 2780-2785.
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