Endothelium-dependent pulmonary artery responses in chronic heart failure: Influence of pulmonary hypertension

Thomas R. Porter, David O. Taylor, Alan Cycan, Jennifer Fields, Cynthia W. Bagley, Natesa G. Pandian, Pramod K. Mohanty

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Abstract

Objectives. The purpose of this study was to determine whether pulmonary artery responses to acetylcholine are abnormal in patients with chronic heart failure. Background. Defective pulmonary artery endothelium-dependent responses have been observed in chronic heart failure models in animals. However, pulmonary artery endothelial response in humans with chronic heart failure are unknown. Methods. Twenty-two patients with chronic treated heart failure (12 with secondary pulmonary hypertension, Group I; 10 with normal pulmonary artery pressure, Group II) and 8 control patients constituted the study groups. Intravascular ultrasound measurements of pulmonary artery area just beyond the tip of an 8F infusion sheath were obtained in response to acetylcholine (10-6, 10-5 and 10-4 mol/liter). The 10-6 mol/liter infusion was repeated after methylene blue infusion. Indomethacin (5 μg/ml) was sequentially added to this combination in 17 patients. Results. There were no significant differences among the three groups in vascular area responses to the lowest concentration (10-6 and 10-5 mol/liter) of acetylcholine, but the 10-4 mol/liter infusion resulted in significant constriction in Group II patients (p < 0.05, analysis of variance [ANOVA]). Pretreatment with methylene blue in Group II also resulted in significant pulmonary artery vasoconstriction to even the 10-6 mol/liter acetylcholine infusion (10.4 ± 7.8% in Group II vs. 1.7 ± 3.9% in the control group and 0.1 ± 4.3% in Group I, p < 0.05, ANOVA). The addition of indomethacin resulted in reversal of the constriction in Group II patients. Conclusions. These responses indicate that the pulmonary artery endothelium may play a significant role in inhibiting vasoconstriction in patients with chronic heart failure who maintain normal pulmonary artery pressure.

Original languageEnglish (US)
Pages (from-to)1418-1424
Number of pages7
JournalJournal of the American College of Cardiology
Volume22
Issue number5
DOIs
StatePublished - Nov 1 1993

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Pulmonary Hypertension
Pulmonary Artery
Endothelium
Heart Failure
Acetylcholine
Methylene Blue
Vasoconstriction
Constriction
Indomethacin
Analysis of Variance
Pressure
Blood Vessels
Animal Models
Control Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Endothelium-dependent pulmonary artery responses in chronic heart failure : Influence of pulmonary hypertension. / Porter, Thomas R.; Taylor, David O.; Cycan, Alan; Fields, Jennifer; Bagley, Cynthia W.; Pandian, Natesa G.; Mohanty, Pramod K.

In: Journal of the American College of Cardiology, Vol. 22, No. 5, 01.11.1993, p. 1418-1424.

Research output: Contribution to journalArticle

Porter, Thomas R. ; Taylor, David O. ; Cycan, Alan ; Fields, Jennifer ; Bagley, Cynthia W. ; Pandian, Natesa G. ; Mohanty, Pramod K. / Endothelium-dependent pulmonary artery responses in chronic heart failure : Influence of pulmonary hypertension. In: Journal of the American College of Cardiology. 1993 ; Vol. 22, No. 5. pp. 1418-1424.
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abstract = "Objectives. The purpose of this study was to determine whether pulmonary artery responses to acetylcholine are abnormal in patients with chronic heart failure. Background. Defective pulmonary artery endothelium-dependent responses have been observed in chronic heart failure models in animals. However, pulmonary artery endothelial response in humans with chronic heart failure are unknown. Methods. Twenty-two patients with chronic treated heart failure (12 with secondary pulmonary hypertension, Group I; 10 with normal pulmonary artery pressure, Group II) and 8 control patients constituted the study groups. Intravascular ultrasound measurements of pulmonary artery area just beyond the tip of an 8F infusion sheath were obtained in response to acetylcholine (10-6, 10-5 and 10-4 mol/liter). The 10-6 mol/liter infusion was repeated after methylene blue infusion. Indomethacin (5 μg/ml) was sequentially added to this combination in 17 patients. Results. There were no significant differences among the three groups in vascular area responses to the lowest concentration (10-6 and 10-5 mol/liter) of acetylcholine, but the 10-4 mol/liter infusion resulted in significant constriction in Group II patients (p < 0.05, analysis of variance [ANOVA]). Pretreatment with methylene blue in Group II also resulted in significant pulmonary artery vasoconstriction to even the 10-6 mol/liter acetylcholine infusion (10.4 ± 7.8{\%} in Group II vs. 1.7 ± 3.9{\%} in the control group and 0.1 ± 4.3{\%} in Group I, p < 0.05, ANOVA). The addition of indomethacin resulted in reversal of the constriction in Group II patients. Conclusions. These responses indicate that the pulmonary artery endothelium may play a significant role in inhibiting vasoconstriction in patients with chronic heart failure who maintain normal pulmonary artery pressure.",
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