Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease
purpose: To assess changes in physiologic shunting and oxygenation following short-term treatment with nifedipine in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease. patients and methods: Changes in pulmonary vascular pressure, pulmonary vascular resistance, v...
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| Veröffentlicht in: | The American journal of medicine 1993-04, Vol.94 (4), p.419-423 |
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| creator | Kalra, Lalit Bone, Michael F. |
| description | purpose: To assess changes in physiologic shunting and oxygenation following short-term treatment with nifedipine in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease.
patients and methods: Changes in pulmonary vascular pressure, pulmonary vascular resistance, venous admixture, and systemic arterial oxygen tension following sublingual administration of 20 mg of nifedipine were studied in 18 patients (13 men, 5 women; mean age of 59.7 [SD 7.2] years) using Swan-Ganz catheterization. These patients had a mean peak expiratory flow rate of 112 (SD 27) L/min (mean 22.2 [SD 12.2]% of predicted value), mean forced expiratory volume in 1 second (FEV
1) of 0.84 (SD 0.23) L (mean 31.2 [SD 8.5]% of predicted value), mean FEV
1/forced vital capacity ratio of 31.6 (SD 4.5), and mean carbon monoxide diffusing capacity of 6.8 (SD 1.96) mmol/min/kPa.
results: There was a significant decrease in mean pulmonary vascular resistance (562 to 371 dyne sec.cm
−5) and a significant reduction in the mean pulmonary arterial pressure (mean 32.8 to 23.6 mm Hg). Pulmonary venous admixture, however, increased significantly from the baseline mean of 44.6% (SD 16.1) to a mean of 56% (SD 15.6), and the mean arterial oxygen tension decreased from 5.8 (SD 1.3) kPa to 4.5 (SD 0.8) kPa at 60 minutes following drug administration (p < 0.001).
conclusion: The role of nifedipine in the treatment of pulmonary hypertension secondary to chronic bronchitis may be limited because of its deleterious effect on venous admixture. |
| doi_str_mv | 10.1016/0002-9343(93)90154-H |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_75693385</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>000293439390154H</els_id><sourcerecordid>7190185</sourcerecordid><originalsourceid>FETCH-LOGICAL-c394t-649e16135820f45cfe579dd07c237f7142ddf2d49fda85367312c9875013ef9a3</originalsourceid><addsrcrecordid>eNp9kU-LFDEQxYMo6zj6DRSCiLiH1vztTC6CLOvOwsJe9ByySWUmS0_SJt2L8-3NOMMcPHipUNTvFZX3EHpLyWdKaP-FEMI6zQX_pPmlJlSKbv0MLaiUslO0Z8_R4oy8RK9qfWwt0bK_QBcroaTm_QLBdQjgJpwDTjGAj2NMgHPC43ZfYx7yJjpct3OaYtpgmzzOv_cbSHaKDYoJu23JqTH5oU5ldlN8AjzOwy4nW_bYxwq2wmv0ItihwpvTu0Q_v1__uFp3d_c3t1ff7jrHtZi6XmigPeVyxUgQ0gWQSntPlGNcBUUF8z4wL3TwdiV5rzhlTq-UJJRD0JYv0cfj3rHkXzPUyexidTAMNkGeq1Gy15w36RK9_wd8zHNJ7TbDOOOEU9I3SBwhV3KtBYIZS9y1bxlKzCECc_DXHPxtxfyNwKyb7N1p9_ywA38WnTxv8w-nua3ODqHY5GI9Y40SShywr0cMmmFPEYqpLkJyLaPSEjM-x__f8Qc99qKP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>232303106</pqid></control><display><type>article</type><title>Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Kalra, Lalit ; Bone, Michael F.</creator><creatorcontrib>Kalra, Lalit ; Bone, Michael F.</creatorcontrib><description>purpose: To assess changes in physiologic shunting and oxygenation following short-term treatment with nifedipine in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease.
patients and methods: Changes in pulmonary vascular pressure, pulmonary vascular resistance, venous admixture, and systemic arterial oxygen tension following sublingual administration of 20 mg of nifedipine were studied in 18 patients (13 men, 5 women; mean age of 59.7 [SD 7.2] years) using Swan-Ganz catheterization. These patients had a mean peak expiratory flow rate of 112 (SD 27) L/min (mean 22.2 [SD 12.2]% of predicted value), mean forced expiratory volume in 1 second (FEV
1) of 0.84 (SD 0.23) L (mean 31.2 [SD 8.5]% of predicted value), mean FEV
1/forced vital capacity ratio of 31.6 (SD 4.5), and mean carbon monoxide diffusing capacity of 6.8 (SD 1.96) mmol/min/kPa.
results: There was a significant decrease in mean pulmonary vascular resistance (562 to 371 dyne sec.cm
−5) and a significant reduction in the mean pulmonary arterial pressure (mean 32.8 to 23.6 mm Hg). Pulmonary venous admixture, however, increased significantly from the baseline mean of 44.6% (SD 16.1) to a mean of 56% (SD 15.6), and the mean arterial oxygen tension decreased from 5.8 (SD 1.3) kPa to 4.5 (SD 0.8) kPa at 60 minutes following drug administration (p < 0.001).
conclusion: The role of nifedipine in the treatment of pulmonary hypertension secondary to chronic bronchitis may be limited because of its deleterious effect on venous admixture.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/0002-9343(93)90154-H</identifier><identifier>PMID: 8475936</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Administration, Sublingual ; Antihypertensive agents ; Biological and medical sciences ; Blood Gas Analysis ; Blood Pressure - drug effects ; Bronchitis ; Cardiovascular disease ; Cardiovascular system ; Catheterization, Swan-Ganz ; Drug therapy ; Female ; Forced Expiratory Flow Rates ; Forced Expiratory Volume ; Humans ; Hypertension ; Hypertension, Pulmonary - drug therapy ; Hypertension, Pulmonary - etiology ; Hypertension, Pulmonary - physiopathology ; Lung Diseases, Obstructive - classification ; Lung Diseases, Obstructive - complications ; Lung Diseases, Obstructive - diagnosis ; Male ; Medical research ; Medical sciences ; Middle Aged ; Nifedipine - administration & dosage ; Nifedipine - pharmacology ; Nifedipine - therapeutic use ; Pharmacology. Drug treatments ; Pulmonary Circulation - drug effects ; Pulmonary Wedge Pressure - drug effects ; Severity of Illness Index ; Vascular Resistance - drug effects ; Vital Capacity</subject><ispartof>The American journal of medicine, 1993-04, Vol.94 (4), p.419-423</ispartof><rights>1993</rights><rights>1993 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Apr 1993</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-649e16135820f45cfe579dd07c237f7142ddf2d49fda85367312c9875013ef9a3</citedby><cites>FETCH-LOGICAL-c394t-649e16135820f45cfe579dd07c237f7142ddf2d49fda85367312c9875013ef9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9343(93)90154-H$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4754746$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8475936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kalra, Lalit</creatorcontrib><creatorcontrib>Bone, Michael F.</creatorcontrib><title>Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>purpose: To assess changes in physiologic shunting and oxygenation following short-term treatment with nifedipine in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease.
patients and methods: Changes in pulmonary vascular pressure, pulmonary vascular resistance, venous admixture, and systemic arterial oxygen tension following sublingual administration of 20 mg of nifedipine were studied in 18 patients (13 men, 5 women; mean age of 59.7 [SD 7.2] years) using Swan-Ganz catheterization. These patients had a mean peak expiratory flow rate of 112 (SD 27) L/min (mean 22.2 [SD 12.2]% of predicted value), mean forced expiratory volume in 1 second (FEV
1) of 0.84 (SD 0.23) L (mean 31.2 [SD 8.5]% of predicted value), mean FEV
1/forced vital capacity ratio of 31.6 (SD 4.5), and mean carbon monoxide diffusing capacity of 6.8 (SD 1.96) mmol/min/kPa.
results: There was a significant decrease in mean pulmonary vascular resistance (562 to 371 dyne sec.cm
−5) and a significant reduction in the mean pulmonary arterial pressure (mean 32.8 to 23.6 mm Hg). Pulmonary venous admixture, however, increased significantly from the baseline mean of 44.6% (SD 16.1) to a mean of 56% (SD 15.6), and the mean arterial oxygen tension decreased from 5.8 (SD 1.3) kPa to 4.5 (SD 0.8) kPa at 60 minutes following drug administration (p < 0.001).
conclusion: The role of nifedipine in the treatment of pulmonary hypertension secondary to chronic bronchitis may be limited because of its deleterious effect on venous admixture.</description><subject>Administration, Sublingual</subject><subject>Antihypertensive agents</subject><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis</subject><subject>Blood Pressure - drug effects</subject><subject>Bronchitis</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Catheterization, Swan-Ganz</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Forced Expiratory Flow Rates</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - drug therapy</subject><subject>Hypertension, Pulmonary - etiology</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Lung Diseases, Obstructive - classification</subject><subject>Lung Diseases, Obstructive - complications</subject><subject>Lung Diseases, Obstructive - diagnosis</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nifedipine - administration & dosage</subject><subject>Nifedipine - pharmacology</subject><subject>Nifedipine - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Pulmonary Circulation - drug effects</subject><subject>Pulmonary Wedge Pressure - drug effects</subject><subject>Severity of Illness Index</subject><subject>Vascular Resistance - drug effects</subject><subject>Vital Capacity</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo6zj6DRSCiLiH1vztTC6CLOvOwsJe9ByySWUmS0_SJt2L8-3NOMMcPHipUNTvFZX3EHpLyWdKaP-FEMI6zQX_pPmlJlSKbv0MLaiUslO0Z8_R4oy8RK9qfWwt0bK_QBcroaTm_QLBdQjgJpwDTjGAj2NMgHPC43ZfYx7yJjpct3OaYtpgmzzOv_cbSHaKDYoJu23JqTH5oU5ldlN8AjzOwy4nW_bYxwq2wmv0ItihwpvTu0Q_v1__uFp3d_c3t1ff7jrHtZi6XmigPeVyxUgQ0gWQSntPlGNcBUUF8z4wL3TwdiV5rzhlTq-UJJRD0JYv0cfj3rHkXzPUyexidTAMNkGeq1Gy15w36RK9_wd8zHNJ7TbDOOOEU9I3SBwhV3KtBYIZS9y1bxlKzCECc_DXHPxtxfyNwKyb7N1p9_ywA38WnTxv8w-nua3ODqHY5GI9Y40SShywr0cMmmFPEYqpLkJyLaPSEjM-x__f8Qc99qKP</recordid><startdate>199304</startdate><enddate>199304</enddate><creator>Kalra, Lalit</creator><creator>Bone, Michael F.</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>199304</creationdate><title>Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease</title><author>Kalra, Lalit ; Bone, Michael F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-649e16135820f45cfe579dd07c237f7142ddf2d49fda85367312c9875013ef9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Administration, Sublingual</topic><topic>Antihypertensive agents</topic><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis</topic><topic>Blood Pressure - drug effects</topic><topic>Bronchitis</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular system</topic><topic>Catheterization, Swan-Ganz</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Forced Expiratory Flow Rates</topic><topic>Forced Expiratory Volume</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - drug therapy</topic><topic>Hypertension, Pulmonary - etiology</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Lung Diseases, Obstructive - classification</topic><topic>Lung Diseases, Obstructive - complications</topic><topic>Lung Diseases, Obstructive - diagnosis</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nifedipine - administration & dosage</topic><topic>Nifedipine - pharmacology</topic><topic>Nifedipine - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Pulmonary Circulation - drug effects</topic><topic>Pulmonary Wedge Pressure - drug effects</topic><topic>Severity of Illness Index</topic><topic>Vascular Resistance - drug effects</topic><topic>Vital Capacity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kalra, Lalit</creatorcontrib><creatorcontrib>Bone, Michael F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kalra, Lalit</au><au>Bone, Michael F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1993-04</date><risdate>1993</risdate><volume>94</volume><issue>4</issue><spage>419</spage><epage>423</epage><pages>419-423</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>purpose: To assess changes in physiologic shunting and oxygenation following short-term treatment with nifedipine in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease.
patients and methods: Changes in pulmonary vascular pressure, pulmonary vascular resistance, venous admixture, and systemic arterial oxygen tension following sublingual administration of 20 mg of nifedipine were studied in 18 patients (13 men, 5 women; mean age of 59.7 [SD 7.2] years) using Swan-Ganz catheterization. These patients had a mean peak expiratory flow rate of 112 (SD 27) L/min (mean 22.2 [SD 12.2]% of predicted value), mean forced expiratory volume in 1 second (FEV
1) of 0.84 (SD 0.23) L (mean 31.2 [SD 8.5]% of predicted value), mean FEV
1/forced vital capacity ratio of 31.6 (SD 4.5), and mean carbon monoxide diffusing capacity of 6.8 (SD 1.96) mmol/min/kPa.
results: There was a significant decrease in mean pulmonary vascular resistance (562 to 371 dyne sec.cm
−5) and a significant reduction in the mean pulmonary arterial pressure (mean 32.8 to 23.6 mm Hg). Pulmonary venous admixture, however, increased significantly from the baseline mean of 44.6% (SD 16.1) to a mean of 56% (SD 15.6), and the mean arterial oxygen tension decreased from 5.8 (SD 1.3) kPa to 4.5 (SD 0.8) kPa at 60 minutes following drug administration (p < 0.001).
conclusion: The role of nifedipine in the treatment of pulmonary hypertension secondary to chronic bronchitis may be limited because of its deleterious effect on venous admixture.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8475936</pmid><doi>10.1016/0002-9343(93)90154-H</doi><tpages>5</tpages></addata></record> |
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| subjects | Administration, Sublingual Antihypertensive agents Biological and medical sciences Blood Gas Analysis Blood Pressure - drug effects Bronchitis Cardiovascular disease Cardiovascular system Catheterization, Swan-Ganz Drug therapy Female Forced Expiratory Flow Rates Forced Expiratory Volume Humans Hypertension Hypertension, Pulmonary - drug therapy Hypertension, Pulmonary - etiology Hypertension, Pulmonary - physiopathology Lung Diseases, Obstructive - classification Lung Diseases, Obstructive - complications Lung Diseases, Obstructive - diagnosis Male Medical research Medical sciences Middle Aged Nifedipine - administration & dosage Nifedipine - pharmacology Nifedipine - therapeutic use Pharmacology. Drug treatments Pulmonary Circulation - drug effects Pulmonary Wedge Pressure - drug effects Severity of Illness Index Vascular Resistance - drug effects Vital Capacity |
| title | Effect of nifedipine on physiologic shunting and oxygenation in chronic obstructive pulmonary disease |
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