A statistical comparison of pulmonary artery and pulmonary venous wedge pressure has been made by the correlation coefficient method in 24 children with various congenital heart disease. None of them had pulmonary hypertension above the normal range. During the systolic phase, pulmonary arterial pressure was 2.02+/-2.64mmHg greater than pulmonary venous wedge pressure with poor correlation(r=0.57). During the diastolic phase, pulmonary venous wedge pressure was 2.08+/-2.47mmHg greater than pulmonary aetery pressure with poor correlation(r=-.63). Mean pulmonary arterial pressure was 0.79+/-1.02mmHg greater than pulmonary venous wedge pressure with good correlation (r=0.96). Therefore, it is concluded that if pulmonary artery is not entered, a pulmonary vein wedge pressure is a useful indication of pulmonary artery mean pressure in selected cases of congenital heart disease.
Arterial Pressure ; Child ; Heart Defects, Congenital* ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Veins ; Pulmonary Wedge Pressure* ; Reference Values

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

In 35 heart failure patients (20 male, 15 female with average age 48±6) in the Hospital 103 from November 2001 to May 2002 the study was carried out. Doppler ultrasound on the heart identified high systolic pressure of pulmonary artery (SPPA). One sublingual capsule of nitroglycerin (0.5 mg) exested a decrease of SPPA in heart failure patient with high SPPA within 5, 10, 15 , 30 and 1 hour. The preparation was well tolerable, with no significant side effects
Heart Failure, Congestive ; Pulmonary Artery ; Patients ; Nitroglycerin ; pressure

In this study, we evaluated systemic and pulmonary hemodynamic changes with the administration of diltiazem into pulmonary artery in hypoxia(F1O2 0.15)-induced pulmonary vasoconstriction in 7 mongrel dogs. Hypoxic gas induced pulmonary vasoconstriction(HPV) resulted in 23.8% increase of mean pulmonary arterial pressure(PAP) without any changes of pulmonary vascular resistance(PVR). A 200 ug/kg intravenous bolus of diltazem, followed by 10 ug/kg/min(DL)and 15 ug/kg/min(DH) for 20 min, respectively, produced no change in pulmonary arterial pressure. But this was accompanied by increase in PVR and PVR/SVR ration in DL and 20 min after DH. We conclude that diltiazem does not seem to decrease acute hypoxic pulmonary vasoconstrition in dogs and it might not be beneficial drug for this kind of pulmoary hypertension.
Animals ; Arterial Pressure ; Diltiazem* ; Dogs* ; Hemodynamics ; Hypertension ; Pulmonary Artery ; Vasoconstriction*

In this study, we evaluated systemic and pulmonary hemodynamic changes with the administration of diltiazem into pulmonary artery in hypoxia(F1O2 0.15)-induced pulmonary vasoconstriction in 7 mongrel dogs. Hypoxic gas induced pulmonary vasoconstriction(HPV) resulted in 23.8% increase of mean pulmonary arterial pressure(PAP) without any changes of pulmonary vascular resistance(PVR). A 200 ug/kg intravenous bolus of diltazem, followed by 10 ug/kg/min(DL)and 15 ug/kg/min(DH) for 20 min, respectively, produced no change in pulmonary arterial pressure. But this was accompanied by increase in PVR and PVR/SVR ration in DL and 20 min after DH. We conclude that diltiazem does not seem to decrease acute hypoxic pulmonary vasoconstrition in dogs and it might not be beneficial drug for this kind of pulmoary hypertension.
Animals ; Arterial Pressure ; Diltiazem* ; Dogs* ; Hemodynamics ; Hypertension ; Pulmonary Artery ; Vasoconstriction*

BACKGROUND: Peripheral venous pressure (PVP) was known to have significant correlation with central venous pressure (CVP) in patients with normal and abnormal cardiac function. The purpose of this study is to evaluate the possibility of PVP as a substitute of CVP for volume status monitoring. METHODS: 41 hypovolemic patients with pulmonary capillary wedge pressure (PCWP) below 10 mmHg, scheduled for elective coronary artery bypass graft were included. CVP and PVP were measured from proximal port of pulmonary artery (PA) catheter and antecubital vein, respectively. Each was connected to the same monitoring system by rigid tubes of same length. Measurements were performed as follows: after PA catheter insertion; after increasing PCWP above 10 mmHg by I.V. fluid infusion; and after anesthesia induction. Hemodynamic variables were recorded at end-expiration after stabilizing for 5 10 minutes. For statistical analysis, Bland and Altman plot was created. RESULTS: The overall mean bias between CVP and PVP was 0.7 mmHg (95% confidence interval, 1 0.5). Limits of agreement of mean bias was 2.1 3.6 mmHg. 118 out of 121 PVP measurements were within the ranges of CVP +/- 3 mmHg (98%). The direction of CVP change was predicted by PVP in 68%. However, larger changes of PVP (> or = 2 mmHg) predicted the changes of CVP with increased accuracy (90%). There were only 5 cases that CVP and PVP had changed in opposite direction. CONCLUSIONS: In conclusion, PVP has a potential to be a substitutional hemodynamic parameter of CVP.
Anesthesia ; Bias (Epidemiology) ; Catheters ; Central Venous Pressure* ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics* ; Humans ; Hypovolemia* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Transplants ; Veins ; Venous Pressure*

To evaluate the relationship between plasma level of immunoreactive atrial natriaretic factor(IR-ANF) and atrial functional index, we studied 28 cardiac patients undergoing cardiac catheterization.Plasma level of IR-ANF in aorta or pulmonary artery was significantly correlated with mean pulmonary capillary wedge pressure, right atrial mean pressure and pulmonary arterial mean pressure, but not with left artrial dimension. To evaluate the relationship between plasma level of IR-ANF and ventricular function index, we selected 13 patients who had normal artrial pressure and no mitral valular disease among 28 patients.Among ventricular functional indices, only left ventricualr end diastolic pressure was significantly correlated with plasma level of IR-ANF in aorta or pulmonary artery. Other indices, such as cardiac index, ejection fraction and aortic systolic blood pressure were not correlated with plasma level of IR-ANF in aorta or pulmonary artery. We concluded that increase in either left atrial pressure may trigger ANF release in man, although ventricles may not be involved in ANF release significantly.
Aorta ; Atrial Natriuretic Factor* ; Atrial Pressure ; Blood Pressure ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Ventricular Function

The authors analyzed data from 15 patients with idiopathic dilated cardiomyopathy to evaluate the hemodynamic changes and left ventricular cineangiogram as compared with normal control. Mean right atrial pressure, right ventricular systolic pressure, mean pulmonary artery pressure and mean pulmonary wedge pressure were signigicantly elevated in patients with dilated cardiomyopathy. Left ventricular enddiastolic volume was increased in idiopathic dilated cardiomyopathy(139.9+/-58.73 ml/m2). Cardiac index, left ventricular ejection fraction and circumferential fiber shortening were significantly reduced in patients with dilated cardiomyopathy as compared with normal control(p<0.001). Hypokinetic, diffuse wall motion abnormalities of left ventricle were common in idiopathic dilated cardiomyopathy. A few cases of akinetic or dyskinetic segmental wall motion abnormalities were present. Left ventricular configurations in patients with idiopathic dilated cardiomyopathy were globe shape(53.4%) as compared with pear core shape(90%) of normal control. Associated mitral regurgitations in patients with idiopathic dilated cardiomyopathy confirmed by left ventricular cineangiogram were 53.3 percent. Mild to moderate mitral regurgitations were often present(46.6%).
Atrial Pressure ; Blood Pressure ; Cardiomyopathy, Dilated* ; Heart Ventricles ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Pyrus ; Stroke Volume

As the mitral valve disease becomes long-standing, the patient may develop pulmonary hypertension. It was reported that after surgical correction, the elevated pulmonary vascular resistance(PVR) would fall quickly in association with the fall in left atrial pressure(LAP). This study was performed to evaluate the changes in mean pulmonary artery pressure(PAP) and PVR immediately after mitral valve replacement(MVR). Fifty six patients undergoing mitral valve replacement(MVR) were divided into two groups on the basis of the presence or absence of significant pulmonary hypertension, defined as a resting mean pulmonary arterial pressure greater than 30mmHg. After induction of anesthesia, PAP, PVR, cardiac output(CO) were measured and compared with values in postbypass period. PAP and PVR were significantly decreased(PAP from 39.64+/-1.88 to 29.18+/-1.65 mmHg, P 0.001, PVR from 6.16+/-1.14 to 3.53+/-0.62 units, P<0.05) in Group II(PAP> or = 30mmHg, n=23), whereas not changed in Group I(PAP30 mmHg, n=33)(P<0.05). Persistance of an elevated PVR may cause right ventricular failure and low-output syndrome, so that an attempt to reduce the PVR is needed postoperatiavely. This study demonstrated that the PAP and PVR fall significantly after MVR especially in patients with severe pulmonary hypertension.
Anesthesia ; Arterial Pressure* ; Humans ; Hypertension, Pulmonary ; Mitral Valve* ; Pulmonary Artery ; Vascular Resistance*

BACKGROUND: Increasing coronary perfusion pressure with phenylephrine is important treatment strategies for right ventricular dysfunction caused by pulmonary hypertension. We compared the effects of phenylephrine on systemic and pulmonary hemondynamics in patients with and without pulmonary hypertension. METHODS: Twenty patients undergoing a valvular replacement were divided into two groups according to pulmonary artery pressure (PAP): control group (mean PAP < 25 mmHg, n = 9) or pulmonary hypertension group (mean PAP > 25 mmHg, n = 11). When systolic blood pressure decreased below 100 mmHg after the induction of anesthesia, phenylephrine was infused to raise systolic blood pressure up to 30% and 50% over baseline. Hemodynamic variables were measured at each time. RESULTS: Phenylephrine failed to raise systolic blood pressure up to 50% above baseline in more than half of the patients with pulmonary hypertension in contrast to successful increases in all patients without pulmonary hypertension. However, the ratio of PAP to systolic blood pressure was significantly reduced in patients whose systolic blood pressure was successfully increased up to 50% over baseline in the pulmonary hypertension group whereas the PAP concomitantly increased as systolic blood pressure was increased in the control group. CONCLUSIONS: Phenylephrine couldn't increase systolic blood pressure in some patients with pulmonary hypertension unlike in control group and it seemed to occur more often in patients with greater the ratio of PAP to systolic blood pressure. The baseline systemic vascular resistance index was high and cardiacoutput was low in the pulmonary hypertension group and these conditions seemed to restrict the effect of phenylephrine.
Anesthesia ; Blood Pressure ; Hemodynamics* ; Humans ; Hypertension, Pulmonary* ; Perfusion ; Phenylephrine* ; Pulmonary Artery ; Vascular Resistance ; Ventricular Dysfunction, Right