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Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction.

Publication ,  Journal Article
Hillman, ND; Cheifetz, IM; Craig, DM; Smith, PK; Ungerleider, RM; Meliones, JN
Published in: J Thorac Cardiovasc Surg
June 1997

OBJECTIVE: In the setting of acute pulmonary artery hypertension, techniques to reduce right ventricular energy requirements may ameliorate cardiac failure and reduce morbidity and mortality. Inhaled nitric oxide, a selective pulmonary vasodilator, may be effective in the treatment of pulmonary artery hypertension, but its effects on cardiopulmonary interactions are poorly understood. METHODS: We therefore developed a model of hypoxic pulmonary vasoconstriction that mimics the clinical syndrome of acute pulmonary hypertension. Inhaled nitric oxide was administered in concentrations of 20, 40, and 80 ppm. RESULTS: During hypoxic pulmonary vasoconstriction, the administration of nitric oxide resulted in a significant improvement in pulmonary vascular mechanics and a reduction in right ventricular afterload. These improvements were a result of selective vasodilation of small pulmonary vessels and more efficient blood flow through the pulmonary vascular bed (improved transpulmonary vascular efficiency). The right ventricular total power output diminished during the inhalation of nitric oxide, indicating a reduction in right ventricular energy requirements. The net result of nitric oxide administration was an increase in right ventricular efficiency. CONCLUSION: These data suggest that nitric oxide may be beneficial to the failing right ventricle by improving pulmonary vascular mechanics and right ventricular efficiency.

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Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

June 1997

Volume

113

Issue

6

Start / End Page

1006 / 1013

Location

United States

Related Subject Headings

  • Ventricular Function, Right
  • Vasoconstriction
  • Swine
  • Respiratory System
  • Pulmonary Gas Exchange
  • Pulmonary Circulation
  • Nitric Oxide
  • Hypoxia
  • Hypertension, Pulmonary
  • Dose-Response Relationship, Drug
 

Citation

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Hillman, N. D., Cheifetz, I. M., Craig, D. M., Smith, P. K., Ungerleider, R. M., & Meliones, J. N. (1997). Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction. J Thorac Cardiovasc Surg, 113(6), 1006–1013. https://doi.org/10.1016/S0022-5223(97)70285-X
Hillman, N. D., I. M. Cheifetz, D. M. Craig, P. K. Smith, R. M. Ungerleider, and J. N. Meliones. “Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction.J Thorac Cardiovasc Surg 113, no. 6 (June 1997): 1006–13. https://doi.org/10.1016/S0022-5223(97)70285-X.
Hillman ND, Cheifetz IM, Craig DM, Smith PK, Ungerleider RM, Meliones JN. Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction. J Thorac Cardiovasc Surg. 1997 Jun;113(6):1006–13.
Hillman, N. D., et al. “Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction.J Thorac Cardiovasc Surg, vol. 113, no. 6, June 1997, pp. 1006–13. Pubmed, doi:10.1016/S0022-5223(97)70285-X.
Hillman ND, Cheifetz IM, Craig DM, Smith PK, Ungerleider RM, Meliones JN. Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction. J Thorac Cardiovasc Surg. 1997 Jun;113(6):1006–1013.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

June 1997

Volume

113

Issue

6

Start / End Page

1006 / 1013

Location

United States

Related Subject Headings

  • Ventricular Function, Right
  • Vasoconstriction
  • Swine
  • Respiratory System
  • Pulmonary Gas Exchange
  • Pulmonary Circulation
  • Nitric Oxide
  • Hypoxia
  • Hypertension, Pulmonary
  • Dose-Response Relationship, Drug