We assessed the concentration of nitroglycerin (GTN) measured in plasma at different sampling sites in the circulation during a constant i.v. infusion. Twenty patients with chronic congestive cardiac failure underwent hemodynamic monitoring during i.v. GTN infusion. Our end point was a reduction in pulmonary capillary wedge pressure by at least 25% of its control value or a 10-fold increment ov...

BACKGROUND Pulmonary hypertension (PH) secondary to left heart failure portends a poor prognosis and is a relative contraindication to heart transplantation at many centers. We tested the hypothesis that when PH persists after adequate left ventricle unloading via recent left ventricular assist device (LVAD) therapy, phosphodiesterase type 5A inhibition would decrease PH in this population. M...

direct, logarithmic, and quantitative relationship between E/A ratio and PA pressure measured as continuous variables in patients with CTEPH. We also documented a similar direct relationship between E/A and cardiac output in the same group. The results of our study expand upon previous studies that have reported on abnormal LV diastolic function in patients with chronic pulmonary hypertension. ...

direct, logarithmic, and quantitative relationship between E/A ratio and PA pressure measured as continuous variables in patients with CTEPH. We also documented a similar direct relationship between E/A and cardiac output in the same group. The results of our study expand upon previous studies that have reported on abnormal LV diastolic function in patients with chronic pulmonary hypertension. ...

N Engl J Med 2004;351:1097-105. Copyright © 2004 Massachusetts Medical Society. A 78-year-old woman with a history of hypertension is admitted to the hospital with congestive heart failure. Physical examination reveals a blood pressure of 180/90 mm Hg, increased jugular venous pressure, peripheral edema, and pulmonary rales. A chest radiograph shows pulmonary edema and mild cardiomegaly. An ech...

We have measured pulmonary artery (PA) and left ventricular diastolic pressures (LVDP) in patients with acute myocardial infarction to establish the relationships of PA pressure to LVDP. Paired determinations for the various parameters showed (mean difference in mm Hg): left ventricular end-diastolic pressure (LVEDP )LVDP pre-a + 7.9, P <0.001; LVEDP-mean PA wedge + 6.0, P < 0.001; mean PA wedg...

We have measured pulmonary artery (PA) and left ventricular diastolic pressures (LVDP) in patients with acute myocardial infarction to establish the relationships of PA pressure to LVDP. Paired determinations for the various parameters showed (mean difference in mm Hg): left ventricular end-diastolic pressure (LVEDP )LVDP pre-a + 7.9, P <0.001; LVEDP-mean PA wedge + 6.0, P < 0.001; mean PA wedg...

BACKGROUND The prevalence of heart failure with preserved ejection fraction is increasing. The prognosis worsens with pulmonary hypertension and right ventricular (RV) failure development. We targeted pulmonary hypertension and RV burden with the phosphodiesterase-5 inhibitor sildenafil. METHODS AND RESULTS Forty-four patients with heart failure with preserved ejection fraction (heart failure...

The new selective 5-HT2 receptor blocking agent ketanserin was given in a dose of 10 mg intravenously to 12 patients with essential hypertension. It caused a distinct fall in supine systemic arterial, right atrial, pulmonary artery, and pulmonary capillary "wedge" pressures. Cardiac output, renal blood flow, and glomerular filtration rate showed no persistent changes. Thus 5-HT2 receptor blocka...