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Right Ventricular Dysfunction: Pathophysiology and Therapy

  • Conference paper
Organfunktion und Stoffwechsel in der perioperativen Phase

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Abstract

This review considers pathophysiology and treatment of right ventricular dysfunction due to an acute increase in afterload. It focuses on cardiovascular complications and treatment of acute pulmonary embolism. However, RV function in severe ARDS is also considered. In addition, effects of pulmonary emboli and drugs on polmonary vascular characteristics per se are reviewed.

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References

  1. Alpert JS, Smith R, Carlson J, Oskene IS, Dexter L, Salen JE (1976) Mortality in patients treated for pulmonary embolism. JAMA 236:1477–1480

    Article  PubMed  CAS  Google Scholar 

  2. Bates ER, Crevey BJ, Sprague FR, Bertram P (1981) Oral hydralazine therapy for acute pulmonary embolism and low output state. Arch Intern Med 141:1537–1538

    Article  PubMed  CAS  Google Scholar 

  3. Chatterjee K, Parmley WW, Massie B, Greenberg B, Werner J, Klausner S, Norman A (1976) Oral hydralazine therapy for chronic refractory heart failure. Circulation 54(6):879–883

    PubMed  CAS  Google Scholar 

  4. Ducas J, Prewitt RM (1985) The effects of hydralazine on the pulmonary vascular pressure-flow relationship after pulmonary emboli. Am Rev Respir Dis 131(4):A409

    Google Scholar 

  5. Ducas J, Deutscher R, Prewitt RM (1985) Inotropic vs vasopressor agents in acute right ventricular failure. Am Rev Respir Dis [Suppl] 131(4):A149

    Google Scholar 

  6. Duval D, Ducas J, Molloy W, Girling L, Prewitt RM (1984) Effects of pulmonary (P) emboli (E) and noradrenaline (NE) on pulmonary pressure-flow relationships. Am Rev Respir Dis 129(4):A63

    Google Scholar 

  7. Fowler NO, Westcott RN, Scott RC, McGuire J (1951) The effects of nor-epinephrine upon pulmonary arteriolar resistance in man. J Cl in Invest 30:517–524

    Article  CAS  Google Scholar 

  8. Ghignone M, Girling L, Prewitt RM (1984a) Effect of increased pulmonary vascular resistance on right ventricular systolic performance in dogs. Am J Physiol 246 [Heart Circ Physiol 15]:H339-H343

    PubMed  CAS  Google Scholar 

  9. Ghignone M, Girling L, Prewitt RM (1984b) Volume expansion vs noradrenaline in treatment of a low cardiac output complicating an acute increase in right ventricular afterload in dogs. Anesthesiology 60:48–51

    Article  Google Scholar 

  10. Ghignone M, Girling L, Prewitt RM (1985) Effects of vasodilators on canine cardiopulmonary function when a decrease in cardiac output complicates an increase in right ventricular afterload. Am Rev Respir Dis 131:527–530

    PubMed  CAS  Google Scholar 

  11. Goldberg HS, Rabson J (1981) Control of cardiac output by systemic vessels — circulatory adjustments of acute and chronic respiratory failure and the effects of therapeutic intervention. Am J Cardiol 47:696–702

    Article  PubMed  CAS  Google Scholar 

  12. Goldberg LI, de V Cotton M, Dorby TD, Howell EV (1953) Comparative heart contractile force effects of equipressor doses of several sympathomimetic amines J Pharmacol Exp Ther 108:177–185

    PubMed  CAS  Google Scholar 

  13. Goldring RM, Turino GM, Cohon G, Jameson AG, Bass BG, Fishman AP (1962) The catecholamines in the pulmonary arterial pressor response to acute hypoxia. J Clin Invest 41:1211–1221

    Article  PubMed  CAS  Google Scholar 

  14. Graham R, Skoog C, Oppenheimer L, Rabson J, Goldberg HS (1982) Critical closure in the canine pulmonary vasculature. Circ Res 50:566–572

    PubMed  CAS  Google Scholar 

  15. Graham R, Skoog C, Macedo W, Carter J, Oppenheimer L, Rabson J, Goldberg HS (1983) Dopamine, dobu-tamine, and phentolamine effects on pulmonary vascular mechanics. J Appl Physiol 54(5): 1277–1283

    PubMed  CAS  Google Scholar 

  16. Hanley AJ (1981) Pulmonary embolism and infarction. In: Emerson P (ed) Thoracic medicine. Butter-worths, London, pp 787–795

    Google Scholar 

  17. Laver MB, Strauss WH, Pohost GM (1975) Herbert Shubin Memorial Lecture. Right and left ventricular geometry: adjustments during acute respiratory failure. Crit Care Med 7:509–519

    Article  Google Scholar 

  18. Lee KY, Molloy DW, Slykerman L, Prewitt RM (1983) Effects of hydralazine and nitroprusside on cardiopulmonary function when a decrease in cardiac output complicates a short-term increase in pulmonary vascular resistance. Circulation 68(6): 1299–1303

    Article  PubMed  CAS  Google Scholar 

  19. McFadden ER, Braunwald E (1981) Cor pulmonale and pulmonary thromboembolism. In: Braunwald E (ed) Heart disease. Saunders, Philadelphia, pp 1643–1680

    Google Scholar 

  20. Mitzner W, Sylvester JT (1981) Hypoxic vasoconstriction and fluid filtration in pig lungs. J Appl Physiol 51(5):1065–1071

    PubMed  CAS  Google Scholar 

  21. Molloy WD, Lee KY, Girling L, Schick U, Prewitt RM (1984) Treatment of shock in a canine model of pulmonary embolism. Am Rev Respir Dis 130:870–874

    PubMed  CAS  Google Scholar 

  22. Molloy DW, Lee KY, Jones D, Penner B, Prewitt RM (1985) Effects of noradrenaline and isoproterenol on cardiopulmonary function in a canine model of acute pulmonary hypertension. Chest (to be published)

    Google Scholar 

  23. Moser KM (1977) Pulmonary embolism. Am Rev Respir Dis 115:829–852

    PubMed  CAS  Google Scholar 

  24. Packer M, Greenberg B, Massie B, Dash H (1982) Deleterious effects of hydralazine in patients with pulmonary hapertension. N Engl J Med 306:1326–1331

    Article  PubMed  CAS  Google Scholar 

  25. Paetkau D, Kettner J, Slykerman L, et al (1982) Effects of treatment on cardiac performance when RV afterload is gradually increased in dogs. J Anesthesiol 57(3A):A56

    Article  Google Scholar 

  26. Petitpretz P, Simmoneay G, Cerrina J, Musset D, Dreyfus M, Vandenbroek M, Duroux P (1984) Effects of a single bolus of urokinase in patients with lifethreatening pulmonary emboli: a descriptive trial. Circulation 70(5):861–866

    Article  PubMed  CAS  Google Scholar 

  27. Phase II results. A cooperative study. (1974) JAMA 229:1606

    Google Scholar 

  28. Pierpont G, Hale KA, Franciosa JA, et al (1980) Effects of vasodilators on pulmonary hemodynamics and gas exchange in left ventricular failure. Am Heart J 99:208

    Article  PubMed  CAS  Google Scholar 

  29. Prewitt RM, Matthay MA, Ghignone M (1984) Hemodynamic management in the adult respiratory distress syndrome. Cardiol, Cl in 2(2):287–304

    Google Scholar 

  30. Rounds S, Kellet M, Jacobs A, Ryan T (1983) Failure of vasodilator responses in primary pulmonary hypertension. Am Rev Respir Dis 127:82

    Google Scholar 

  31. Rubin LJ, Peter RH (1980) Oral hydralazine therapy for primary pulmonary hypertension. N Engl J Med 302:69

    Article  PubMed  CAS  Google Scholar 

  32. Rubin LJ, Peter RH (1981) Hemodynamics at rest and during exercise after oral hydralazine in patients with cor pulmonale. Am J Cardiol 47:116

    Article  PubMed  CAS  Google Scholar 

  33. Salisbury PF (1955) Coronary artery pressure and strength of right ventricular contraction. Circ Res 3:633–638

    PubMed  CAS  Google Scholar 

  34. Sashara AA (1980) Controversy: the use of fibrinolytic therapy. J Cardiovasc Med 5:793–814

    Google Scholar 

  35. Sharma GVRK, McIntyre KM (1984) Pulmonary Embolism Cardiol Clin 2(2):269–274

    CAS  Google Scholar 

  36. Snider MT, Rie MA, Lauer J, et al (1980) Normoxic pulmonary vasoconstriction in ARDS: Detection by sodium nitroprusside (N) and isoproterenol (I) infusions at Massachusetts General Hospital, Boston, Massachusetts. Am Rev Respir Dis [Suppl] 121:191

    Google Scholar 

  37. Spotnitz HM, Berman MA, Epstein SE (1971) Pathophysiology and experimental treatment of acute pulmonary embolism. Am Heart J 82:511–520

    Article  PubMed  CAS  Google Scholar 

  38. Stein PD, Sabbah HN, Anbe DT, Marzilli M (1979) Performance of the failing and nonfailing right ventricle of patients with pulmonary hypertension. Am J Cardiol 44:1050–1055

    Article  PubMed  CAS  Google Scholar 

  39. Urokinase Pulmonary Embolism Study Group (1973) Urokinase pulmonary embolism trial. Circulation 47:66–73

    Google Scholar 

  40. Urokinase Pulmonary Embolism Trial (UPET) (1973) Circulation: 47 [Suppl II]: II—I

    Google Scholar 

  41. Vlahakes GJ, Turley K, Hoffman JIE (1981) The pathophysiology of failure in acute right ventricular hypertension: hemodynamic and biochemical correlations. Circulation 63:87–95

    Article  PubMed  CAS  Google Scholar 

  42. Weiner N (1980) Norepinephrine, epinephrine and the sympathomimetic amines. In: Gilman AG, Goodman LS, Gilman E (eds) Goodman and Gilman’s. The pharmacological basis of therapeutics. MacMil-lan, New York, pp 151–155

    Google Scholar 

  43. West JW, Aviado DM (1956) Cardiac output of methoxamine with special reference to intracoronary injection. Am J Med Sci 231:599–600

    Google Scholar 

  44. Wolff FW (1954) Shock due to pulmonary embolism: treatment with 1-noradrenaline. Lancet 2:72–73

    Article  Google Scholar 

  45. Wood LDH, Prewitt RM (1981) Cardiovascular management in acute hypoxemic respiratory failure. Am J Cardiol 47:963

    Article  PubMed  CAS  Google Scholar 

  46. Zapol WM, Snider MT (1977) Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 296:476–480

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. J. Ducas
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  2. R. M. Prewitt
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Editor information

Editors and Affiliations

  1. Klinikum Steglitz der FU Berlin, Hindenburgdamm 30, 1000, Berlin 45, Deutschland

    Konrad Reinhart  & Klaus Eyrich  & 

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© 1985 Springer-Verlag Berlin Heidelberg

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Ducas, J., Prewitt, R.M. (1985). Right Ventricular Dysfunction: Pathophysiology and Therapy. In: Reinhart, K., Eyrich, K. (eds) Organfunktion und Stoffwechsel in der perioperativen Phase. Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine, vol 180. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70798-8_13

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  • DOI: https://doi.org/10.1007/978-3-642-70798-8_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-15925-4

  • Online ISBN: 978-3-642-70798-8

  • eBook Packages: Springer Book Archive

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