Hemodynamic and gas exchange effects of intravenous diltiazem in patients with pulmonary hypertension

Crevey, Barry J.; Dantzker, David R.; Bower, James S.; Popat, Kishor D; Walker, Steven D.

doi:10.1016/s0002-9149(82)80015-5

Cited by 57 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with acute respiratory failure, we did not observe any deleterious effect of diltiazem on the pulmonary gas exchange or ventilation-perfusion distribution as assessed by arterial pO2. This is in agreement with a small previous study that demonstrated the lack of worsening of pulmonary gas exchange after pulmonary vasodilatation induced by intravenous diltiazem in patients with pulmonary hypertension [17].…”

Section: Safetysupporting

confidence: 94%

Usefulness of diltiazem in the acute management of supraventricular tachyarrhythmias in the elderly

Millaire

Leroy

Groote

et al. 1996

Cardiovasc Drug Ther

View full text Add to dashboard Cite

Acute management of supraventricular tachyarrhythmias is often difficult in elderly patients. Diltiazem was given intravenously (loading dose of 0.25 mg/kg over 2 minutes followed by a 4 mg/kg/24 hr infusion) in 37 elderly patients (mean age 70 years, range 60-91). Fifteen out of the 37 patients (41%) had left ventricular cardiac disease, 12 (32%) had cor pulmonale, and 10 (27%) had no obvious cardiac disease. Hemodynamic tolerance of the supraventricular tachyarrhythmia was poor in 12 patients. A good result was defined as a return to sinus rhythm after bolus or infusion, or as a slowing of the ventricular rate (VR) to less than 100 beats/min. Of the 23 patients in atrial fibrillation, about half reverted to sinus rhythm after diltiazem, and in most of the others the ventricular rate decreased to less than 100 beats/min. Side effects occurred in 10 patients (bradycardia in 6, cutaneous rash in 2, hypotension in 2). They rapidly reversed after cessation of diltiazem. They were responsible for 2 out of the 5 poor results. Thus, diltiazem appeared effective and safe when used carefully in elderly patients with supraventricular tachyarrhythmia.

show abstract

Section: Safetysupporting

confidence: 94%

Usefulness of diltiazem in the acute management of supraventricular tachyarrhythmias in the elderly

Millaire

Leroy

Groote

et al. 1996

Cardiovasc Drug Ther

View full text Add to dashboard Cite

show abstract

“…1999) and two clinical studies had also shown a reduction of PH in patients after diltiazem administration (Kambara et al . 1981; Crevey et al . 1982).…”

Section: Discussionmentioning

confidence: 99%

Calcium antagonists, diltiazem and nifedipine, protect broilers against low temperature‐induced pulmonary hypertension and pulmonary vascular remodeling

Yang

Gao

Lee³

et al. 2010

Animal Science Journal

View full text Add to dashboard Cite

This study was designed to determine whether calcium antagonists, diltiazem and nifedipine, can depress low temperature-induced pulmonary hypertension (PH) in broilers (also known as ascites) and to characterize their efficacy on hemodynamics and pulmonary artery function. Chicks were randomly allocated into six experimental groups and orally administered with vehicle, 5.0 mg/kg body weight (BW)/12 h nifedipine or 15.0 mg/kg BW/12 h diltiazem from 16 to 43 days of age under low temperature. The mean pulmonary arterial pressure (mPAP), the ascites heart index (AHI), the erythrocyte packed cell volume (PCV) and the relative percentage of medial pulmonary artery thickness were examined on days 29, 36 and 43. The data showed that administration of diltiazem protected broilers from low temperature-induced pulmonary hypertension and vascular remodeling. Although nifedipine prevented mPAP from increasing during the early stage, it did not suppress the development of PH during the late stage and did not keep heart rate (HR), PCV, AHI and the thickness of pulmonary small artery smooth muscle layer at the normal levels. Taken together, our results showed that diltiazem can effectively prevent low temperature-induced pulmonary hypertension in broilers with fewer side-effects and may be a potential compound for the prevention of this disease in poultry industry.

show abstract

“… 44 , 46 , 47 On the other hand, occurrence of life-threatening hemodynamic compromise has often been documented in CCB testing (nifedipine and verapamil). 48 – 51 Therefore, it is accepted that CCBs should not be used for acute testing. 3 , 42 In contrast, intravenous CCB nicardipine might be useful for acute testing, 52 because the drug is short-acting compared to nifedipine and more vasoselective than other CCBs.…”

Section: Acute Vasoreactivity Testingmentioning

confidence: 99%

Epoprostenol sodium for treatment of pulmonary arterial hypertension

Saito¹,

Nakamura²,

Akagi³

et al. 2015

VHRM

View full text Add to dashboard Cite

The release of endogenous prostacyclin (PGI2) is depressed in patients with pulmonary arterial hypertension (PAH). PGI2 replacement therapy by epoprostenol infusion is one of the best treatments available for PAH. Here, we provide an overview of the current clinical data for epoprostenol. Epoprostenol treatment improves symptoms, exercise capacity, and hemodynamics, and is the only treatment that has been shown to reduce mortality in patients with idiopathic PAH (IPAH) in randomized clinical trials. We have reported that high-dose epoprostenol therapy (>40 ng/kg/min) also results in marked hemodynamic improvement in some patients with IPAH. High-dose epoprostenol has a pro-apoptotic effect on PAH-PASMCs via the IP receptor and upregulation of Fas ligand (FasL) in vitro. However, long-term intravenous administration of epoprostenol is sometimes associated with catheter-related infections and leads to considerable inconvenience for the patient. In the future, the development of new routes of administration or the development of powerful PGI2 analogs, IP-receptor agonists, and gene and cell-based therapy enhancing PGI2 production with new routes of administration is required.

show abstract

Hemodynamic and gas exchange effects of intravenous diltiazem in patients with pulmonary hypertension

Cited by 57 publications

References 17 publications

Usefulness of diltiazem in the acute management of supraventricular tachyarrhythmias in the elderly

Usefulness of diltiazem in the acute management of supraventricular tachyarrhythmias in the elderly

Calcium antagonists, diltiazem and nifedipine, protect broilers against low temperature‐induced pulmonary hypertension and pulmonary vascular remodeling

Epoprostenol sodium for treatment of pulmonary arterial hypertension

Contact Info

Product

Resources

About