Skip to main content

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

Publication ,  Journal Article
Armstrong, PW
Published in: Can Med Assoc J
October 6, 1979

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.

Duke Scholars

Published In

Can Med Assoc J

ISSN

0008-4409

Publication Date

October 6, 1979

Volume

121

Issue

7

Start / End Page

913 / 918

Location

Canada

Related Subject Headings

  • Vasodilator Agents
  • Teprotide
  • Prazosin
  • Phentolamine
  • Nitroprusside
  • Nitrates
  • Monitoring, Physiologic
  • Hydralazine
  • Humans
  • Hemodynamics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Armstrong, P. W. “Contributions of hemodynamic monitoring to the treatment of chronic congestive heart failure.Can Med Assoc J 121, no. 7 (October 6, 1979): 913–18.
Armstrong, P. W. “Contributions of hemodynamic monitoring to the treatment of chronic congestive heart failure.Can Med Assoc J, vol. 121, no. 7, Oct. 1979, pp. 913–18.

Published In

Can Med Assoc J

ISSN

0008-4409

Publication Date

October 6, 1979

Volume

121

Issue

7

Start / End Page

913 / 918

Location

Canada

Related Subject Headings

  • Vasodilator Agents
  • Teprotide
  • Prazosin
  • Phentolamine
  • Nitroprusside
  • Nitrates
  • Monitoring, Physiologic
  • Hydralazine
  • Humans
  • Hemodynamics