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Effects of piroximone on the right ventricular function in severe heart failure patients

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Abstract

Objectives

To assess the effects of piroximone, a phosphodiesterase inhibitor, on right ventricular function in patients with heart failure.

Design

Randomized study: patients were randomly assigned to the piroximone infusion rate of 5 or 10 μg/kg/min.

Setting

Cardiologic intensive care unit.

Patients

12 consecutive patients with severe heart failure.

Interventions

Right heart catheterization was performed using a Swan-Ganz ejection fraction thermodilution catheter.

Measurements and results

Measurements of right ventricular ejection fraction (RVEF), end-diastolic and end-systolic right ventricular volumes were obtained using the thermodilution principle. To determine contractility indexes, the relationships between end-systolic pulmonary arterial pressure (ESPAP) over right ventricular end-systolic volume (RVESV) and ESPAP over RVEF were calculated during the infusion of prostacyclin at incremental infusion rates of 2, 4, 6 and 8 ng/kg/min. The slope of the relation between ESPAP over RVESV shifted during piroximone therapy from 7.635±1.632 to 1.975±0.432 (p<0.01) and from 6.092±1.99 to 1.028±0.853 (p<0.05) at 5 and 10 μg/kg/min piroximone infusion, respectively. The slope of the relation between ESPAP over RVEF decreased from −0.414±0.296 to −0.821±0.257 (p<0.01) and from −0.127±0.048 to −0.533±0.135 (p<0.05) at 5 and 10 μg/kg/min piroximone infusion, respectively.

Conclusions

This study suggests a positive action of piroximone on right ventricular contractility at these 2 dosages. This approach using this type of catheter allowed us to determine right ventricular inotropic indexes.

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Authors and Affiliations

  1. Département de Cardiologie and INSERM U2, Hôpital Henri Mondor, F-94010, Créteil, France

    J. P. Saal, R. Habbal, P. Estagnasie, D. Lellouche, A. Castaigne &  J. L. Dubois-Randé

Authors
  1. J. P. Saal
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  2. R. Habbal
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  3. P. Estagnasie
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  4. D. Lellouche
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  5. A. Castaigne
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  6. J. L. Dubois-Randé
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Saal, J.P., Habbal, R., Estagnasie, P. et al. Effects of piroximone on the right ventricular function in severe heart failure patients. Intensive Care Med 20, 341–347 (1994). https://doi.org/10.1007/BF01720906

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  • DOI: https://doi.org/10.1007/BF01720906

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