Nitroprusside and regional vascular capacitance in patients with severe congestive heart failure.

Risøe, Cecilie; Simonsen, Svein; Rootwelt, K; Sire, S; Smiseth, O A

doi:10.1161/01.cir.85.3.997

Cited by 14 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reduction in LV filling pressure with nitrates are complex and may be due to improvement in afterloaddependent relaxation delay, decrease in chamber volume from venodilation, acute improvement in diastolic compliance, or relief of pericardial constraint (6,7,(23)(24)(25). Absent volume data obtained at the time of catheterization, we cannot determine the relative roles these mechanisms played in the current study.…”

mentioning

confidence: 89%

Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction

Schwartzenberg

Redfield

From

et al. 2012

Journal of the American College of Cardiology

298

196

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 89%

Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction

Schwartzenberg

Redfield

From

et al. 2012

Journal of the American College of Cardiology

298

196

View full text Add to dashboard Cite

show abstract

“…No significant differences were noted between the control (C) splanchnic vascular V-P curve (average of control 1 and control 2 data) and those recorded 2-6 minutes (PLB-1), 9-13 minutes (PLB-2), and 20-24 minutes (PLB-3) after sublingual administration of PLB (p>0. 52 The few studies of the human splanchnic veinS5-7, 25,28,33,36,37 have assessed changes in SVV during acute interventions, but venous V-P relations have never been defined.…”

Section: Effect Of Nitroglycerin (Group 1)mentioning

confidence: 99%

Assessment of the human splanchnic venous volume-pressure relation using radionuclide plethysmography. Effect of nitroglycerin.

et al. 1993

View full text Add to dashboard Cite

BACKGROUND No method exists to assess human splanchnic venous function, the most important region in terms of vascular capacity. METHODS AND RESULTS We studied 25 stable patients without heart failure or hypertension to develop a method to assess the splanchnic venous volume-pressure (V-P) relation and to determine the effect of nitroglycerin (GTN). We used blood pool scintigraphy to assess changes in regional splanchnic vascular volume (SVV) and low levels of continuous positive airway pressure (CPAP) to passively alter venous pressure and thus, SVV. We postulated that the relation between SVV and the CPAP used would reflect the capacitance of the splanchnic venous bed and that changes in the position of this relation would provide a relative measurement of any change in capacitance. In 12 patients (group 1), the splanchnic vascular V-P curves were recorded before and 2, 9, and 20 minutes after 0.6 mg sublingual GTN; in eight patients (group 2), recordings were made at similar times before and after sublingual administration of placebo; in five patients (group 3), the hemodynamic effects of CPAP were assessed by means of right and left cardiac catheterization. Right atrial and femoral venous pressures increased (p < 0.001) and cardiac output fell (p < 0.05) during CPAP. There was an apparently linear relation between CPAP and SVV (r = 0.74-0.98); SVV increased an average of 7.4 +/- 2.2% (p < 0.001) by 12 cm H2O CPAP: The splanchnic vascular V-P curves were reproducible with minimal variability in SVV (+/- 2%, p > 0.2) in group 2. After administration of GTN, the splanchnic vascular V-P curve shifted away from the pressure axis in a parallel fashion by an average of 9.4 +/- 5.4% (p < 0.001). CONCLUSIONS We have developed a reproducible noninvasive technique that may be used to assess human splanchnic venous V-P relations. We have demonstrated for the first time in humans that GTN exerts its dilatory effect by increasing the unstressed splanchnic venous volume.

show abstract

“…liver, spleen and mesenteric vasculature) contain the majority of intravascular blood volume making it the main source of vascular capacitance both in animals 10,[12][13][14] and in humans. 10,13,[15][16][17][18][19] In contrast, only around 10% of the total blood volume is located in the extremities at rest. The splanchnic vasculature is innervated with a vast network of adrenergic neurons, 20 which is far greater on the venous compared to the arterial system.…”

Section: Role Of the Splanchnic Nerves And Splanchnic Compartment In Heart Failurementioning

confidence: 99%

Splanchnic nerve modulation in heart failure: mechanistic overview, initial clinical experience, and safety considerations

Fudim

Ponikowski

Burkhoff

et al. 2021

European J of Heart Fail

View full text Add to dashboard Cite

Volume recruitment from the splanchnic compartment is an important physiological response to stressors such as physical activity and blood loss. In the setting of heart failure (HF), excess fluid redistribution from this compartment leads to increased cardiac filling pressures with limitation in exercise capacity. Recent evidence suggests that blocking neural activity of the greater splanchnic nerve (GSN) could have significant benefits in some patients with HF by reducing cardiac filling pressures and improving exercise capacity. However, to date the long-term safety of splanchnic nerve modulation (SNM) in the setting of HF is unknown. SNM is currently used in clinical practice to alleviate some forms of chronic abdominal pain. A systematic review of the series where permanent SNM was used as a treatment for chronic abdominal pain indicates that permanent SNM is well tolerated, with side-effects limited to transient diarrhoea or abdominal colic and transient hypotension. The pathophysiological role of the GSN in volume redistribution, the encouraging findings of acute and chronic pilot SNM studies and the safety profile from permanent SNM for pain provides a strong basis for continued efforts to study this therapeutic target in HF.

show abstract

Nitroprusside and regional vascular capacitance in patients with severe congestive heart failure.

Abstract: Nitroprusside reduced venous pressure in patients with congestive heart failure by active relaxation of intestinal and pulmonary capacitance vessels. Hepatic vascular volume was probably reduced by a passive mechanism.

Cited by 14 publications

References 24 publications

Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction

Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction

Assessment of the human splanchnic venous volume-pressure relation using radionuclide plethysmography. Effect of nitroglycerin.

Splanchnic nerve modulation in heart failure: mechanistic overview, initial clinical experience, and safety considerations

Contact Info

Product

Resources

About