Contributions of hemodynamic monitoring to the treatment of chronic congestive heart failure.

Published

Journal Article

Optimal therapy for congestive cardiac failure requires identification of correctable factors that aggravate it as well as an understanding of its etiology. Increased sympathetic nervous system activity, reduced renal blood flow, and cardiac hypertrophy and dilation are the main compensatory processes that occur in response to cardiac failure. Although they may be of initial benefit in supporting a reduced stroke volume, they may ultimately prove self-defeating. New drugs for the treatment of severe congestive heart failure include dopamine, which has a selective nonadrenergic dilator effect on the renal vascular bed, and dobutamine, which has potent inotropic effects, lowers the left ventricular filling pressure and does not increase the heart rate or the systemic vascular resistance. By reducing both the resistance to left ventricular ejection and the venous return to the right heart, vasodilators result in improved peripheral perfusion and reduced pulmonary congestion. Optimal therapy for refractory cardiac failure can be rationally determined by characterizing the hemodynamic profile through measurement of the mean arterial pressure, the left ventricular filling pressure, the cardiac output and the systemic vascular resistance. The specific therapy can then be effectively and safely delivered by a careful analysis of the dose-response relation as identified by hemodynamic monitoring.

Full Text

Duke Authors

Cited Authors

  • Armstrong, PW

Published Date

  • October 6, 1979

Published In

Volume / Issue

  • 121 / 7

Start / End Page

  • 913 - 918

PubMed ID

  • 497982

Pubmed Central ID

  • 497982

International Standard Serial Number (ISSN)

  • 0008-4409

Language

  • eng

Conference Location

  • Canada