Influence of inhaled nitric oxide on systemic flow and ventricular filling pressure in patients receiving mechanical circulatory assistance

Joshua M. Hare, Stanton K. Shernan, Simon C. Body, Erin Graydon, Wilson S. Colucci, Gregory S. Couper

Research output: Contribution to journalArticle

Abstract

Background: In patients with left ventricular (LV) dysfunction, inhaled nitric oxide (NO) decreases pulmonary vascular resistance (PVR) but causes a potentially clinically significant increase in left atrial pressure (LAP). This has led to the suggestion that inhaled NO may reach the coronary circulation and have a negative inotropic effect. This study tested an alternative hypothesis that LAP increases because of volume shifts to the pulmonary venous compartment caused by NO-induced selective pulmonary vasodilation. Methods and Results: The Thermo Cardiosystems Heartmate is an LV assist device (LVAD) that can be set (by controlling pump rate) to deliver fixed or variable systemic blood flow. Eight patients (between 1 and 11 days after LVAD implantation) were administered inhaled NO (20 and 40 ppm for 10 minutes), and LAP, systemic flow, and pulmonary arterial pressure were measured in both fixed and variable pump flow modes. In both modes, inhaled NO lowered PVR (by 25±6% in the fixed mode, P

Original languageEnglish (US)
Pages (from-to)2250-2253
Number of pages4
JournalCirculation
Volume95
Issue number9
Publication statusPublished - 1997

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Keywords

  • assist device
  • heart failure
  • hypertension, pulmonary
  • vasodilators
  • ventricles

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Hare, J. M., Shernan, S. K., Body, S. C., Graydon, E., Colucci, W. S., & Couper, G. S. (1997). Influence of inhaled nitric oxide on systemic flow and ventricular filling pressure in patients receiving mechanical circulatory assistance. Circulation, 95(9), 2250-2253.