Piroximone, dobutamine and nitroprusside: comparative effects on haemodynamics in patients with congestive heart failure.

Authors

G Baumann
K Ningel
Johannes Vieweg, Nova Southeastern UniversityFollow
A M Joder-Ohlenbusch
G Cremer

Publication Title

European heart journal

Publisher

Oxford University Press

ISSN

0195-668X

Publication Date

4-1-1991

Keywords

Adult, Aged, Analysis of Variance, Cardiotonic Agents, Dobutamine, Female, Heart Failure, Hemodynamics, Humans, Imidazoles, Male, Middle Aged, Nitroprusside, Random Allocation

Abstract

Four intravenous doses of piroximone, an imidazolone derivative, were administered to 12 patients with congestive heart failure to produce a four-point dose-response curve. The haemodynamic effects were compared with those of dobutamine and nitroprusside, the substances being given sequentially and in randomized order. Piroximone and dobutamine significantly and similarly increased cardiac index (CI) and stroke volume index (SVI). Nitroprusside produced no such effect. By contrast, piroximone and nitroprusside significantly and similarly decreased mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), right atrial pressure (RAP) and pulmonary vascular resistance (PVR), while such changes were not seen following dobutamine. Direct comparisons between the agents were made at doses that lowered systemic vascular resistance (SVR) to the same extent. The major difference between dobutamine and piroximone was an apparent additional vasodilator activity displayed by piroximone as demonstrated by a significantly greater decrease in MPAP, PCWP and RAP for a matched reduction in SVR and a similar increase in CI. The major difference between nitroprusside and piroximone was the significantly higher increase in CI and SVI elicited by piroximone for a matched reduction in SVR and a similar decrease in PCWP and RAP. The changes in loading conditions being equivalent, the higher increase in CI is likely to be accounted for by a direct inotropic activity.

Volume

12

Issue

4

First Page

533

Last Page

540

Disciplines

Medicine and Health Sciences

NSUWorks Citation

Baumann, G; Ningel, K; Vieweg, Johannes; Joder-Ohlenbusch, A M; and Cremer, G, "Piroximone, dobutamine and nitroprusside: comparative effects on haemodynamics in patients with congestive heart failure." (1991). NSU-MD Faculty Articles. 7.
https://nsuworks.nova.edu/hpd_md_facarticles/7