Pulmonary arterial hypertension (PAH) is a progressive disease that ultimately leads to right heart failure and death. PAH is defined as a mean pulmonary arterial pressure ≥ 25 mm Hg with a pulmonary capillary wedge pressure ≤ 15 mm Hg at rest. The diagnosis of PAH is one of exclusion; diagnostics include an extensive history, serology, chest radiograph, pulmonary function tests, ventilation/pe...

BACKGROUND Elevated plasma endothelin-1 (ET-1) levels in patients with chronic heart failure correlate with pulmonary artery pressures and pulmonary vascular resistance. ET(A) receptors on vascular smooth muscle cells mediate pulmonary vascular contraction and hypertrophy. We determined the acute hemodynamic effects of sitaxsentan, a selective ET(A) receptor antagonist, in patients with chronic...

BACKGROUND In patients with heart failure, pulmonary hypertension (PH) predicts higher risk for morbidity and mortality. However, few data are available on the prognostic implications of reactive (precapillary) PH superimposed on passive (postcapillary) PH. METHODS AND RESULTS We performed a subgroup analysis of 242 patients with acute decompensated heart failure assigned to pulmonary artery ...

COMMUNICATIONS TO THE EDITOR 693 operation. Preston’s insinuation that cardiologists and surgeons are recommending aortocoronary bypass surgery for personal economic reasons is one of the most insulting things that I have ever read in a medical journal. Did it ever occur to him that the results he reads about in journals and sees in government-funded hospitals might not be the same as the resul...

Positive end-expiratory pressure (PEEP) is effective in improving arterial oxygenation and decreasing intrapulmonary shunt in patients with the adult respiratory distress syndrome [9, 121. PEEP can also cause a significant reduction in cardiac output [6, 8, 13, 15]anddecreaseinoxygendelivery[12]. The decrease in cardiac output may be due to impaired venous return [ 1, 7, 141, pulmonary vascular...

The haemodynamic effects of infusing sodium nitroprusside or trinitroglycerine to control hypertension during operation were compared in 22 patients undergoing coronary artery surgery. Measurements were taken before induction of anaesthesia, during median sternotomy, and upon attainment of a stable decrease in arterial pressure. Both drugs significantly decreased arterial pressure without affec...

INTRODUCTION AND OBJECTIVES Levosimendan is an inotropic agent that is effective in the treatment of heart failure. However, experience with levosimendan in patients with reduced cardiac output following cardiopulmonary bypass is limited. The objective of this study was to compare the short-term hemodynamic effects of levosimendan with those of dobutamine in managing low cardiac output after ca...