NSU-MD Faculty Articles
Title
Piroximone, dobutamine and nitroprusside: comparative effects on haemodynamics in patients with congestive heart failure.
ISBN or ISSN
0195-668X
Publication Title
European heart journal
Volume
12
Issue
4
Publication Date / Copyright Date
4-1-1991
First Page
533
Last Page
540
Publisher
Oxford University Press
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.
Disciplines
Medicine and Health Sciences
Keywords
Adult, Aged, Analysis of Variance, Cardiotonic Agents, Dobutamine, Female, Heart Failure, Hemodynamics, Humans, Imidazoles, Male, Middle Aged, Nitroprusside, Random Allocation
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
