Effect of progressive pressure reduction with nitroprusside on acute myocardial infarction in humans. Determination of optimal afterload

M. M. Bodenheimer, K Ramanathan, V. S. Banka, R. H. Helfant

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The effect of nitroprusside-induced progressive systemic pressure reduction on segmental function in patients with acute myocardial infarction is unclear. In 15 patients control radionuclide angiograms were obtained at control within 24 hr of the onset of chest pain and during the administration of intravenous nitroprusside. The initial study showed a significant reduction in hemiaxial shortening in the zone of myocardial infarction. With nitroprusside, systolic pressure was decreased from a mean of 133 mm Hg to an intermediate pressure of 116 mm Hg (p<0.001). At this pressure central chord hemiaxial shortening increased in 8 of 15 zones with an average increase from 10.1% to 27.8% (p<0.006). After further reduction in pressure to 87.1 mm Hg, and additional 5 of the 7 remaining zones of acute infarction improved. However, of the 8 zones that improved initially, 4 deteriorated at the lowest pressure. Similar changes were seen in the lateral chords. Thus, afterload reduction can improve hemiaxial shortening of the infarct zone. However, the degree of reduction in systemic pressure must be individualized to avoid adverse effects of an excessive decrease in perfusion pressure.

Original languageEnglish (US)
Pages (from-to)435-439
Number of pages5
JournalAnnals of Internal Medicine
Volume94
Issue number4 I
StatePublished - 1981
Externally publishedYes

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Nitroprusside
Myocardial Infarction
Pressure
Chest Pain
Radioisotopes
Intravenous Administration
Infarction
Angiography
Perfusion
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Effect of progressive pressure reduction with nitroprusside on acute myocardial infarction in humans. Determination of optimal afterload. / Bodenheimer, M. M.; Ramanathan, K; Banka, V. S.; Helfant, R. H.

In: Annals of Internal Medicine, Vol. 94, No. 4 I, 1981, p. 435-439.

Research output: Contribution to journalArticle

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