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4261. Systemic vasoconstrictor and renal vasodilator effects of PLV-2 (octapressin) in man.
The systemic and renal hemodynamic effects of PLV-2 (octapressin) were studied in patients with hypotension or decompensated cirrhosis of the liver. Low doses (0.004 to 0.02 units/min) increased renal blood flow (indicator-dilution technique), reduced renal vascular resistance, and produced a slight increase in arterial pressure and systemic vascular resistance. Higher doses (0.1 to 0.5 units/min) produced a sharp increase in arterial pressure and systemic resistance while renal resistance increased moderately and renal blood flow usually was maintained above control levels. Renal fraction was increased at all dose levels. The increased renal blood flow was accompanied by more rapid intrarenal dye transit time and slight increase in renal extraction ratio of paraaminohippurate suggesting a rise in cortical blood flow. It is concluded that PLV-2 in small doses produces renal vasodilation and in larger doses preferential extra-renal vasoconstriction resulting in redistribution of blood flow to the kidney.
4262. Effects of acetylcholine on regional pulmonary blood flow in patients with mitral stenosis.
The effect of acetylcholine was studied on the region of increased vascular resistance at the lung bases in patients with mitral stenosis. The patients had moderate elevations of pulmonary artery pressure. The distribution of blood flow and ventilation were measured in both lungs of 10 patients using radioactive xenon-133 and a scanning technique. Acetylcholine was then infused into one main pulmonary artery, and the distribution of blood flow and ventilation were measured again. One lung served as a control during the drug infusion. There was a small but significant increase in perfusion to the dependent lung zone during the drug infusion without a change in pulmonary artery pressure indicating localized vasodilation. Relative underperfusion was still present during the acetylcholine administration which indicated that increased vasomotor tone was not the principal pathophysiological mechanism for the increased vascular resistance. There was a decrease in ventilation to the lower zone of the lung receiving acetylcholine.
4263. Annuloplasty in children and young adolescents with severe rheumatic mitral insufficiency.
作者: H H Kloth.;G E Reed.;D A Tice.;E F Doyle.;B Kiely.;M Spagnuolo.
来源: Circulation. 1968年38卷1期103-12页
Eleven patients aged 8 to 15 years underwent measured asymmetrical annuloplasty for severe mitral regurgitation in the years 1961 through 1966. They had had a total of 20 attacks of acute rheumatic fever. The intervals between the last attack of acute rheumatic fever and operation ranged from 2 to 8 years. The criteria for surgery were congestive failure and progressive cardiac enlargement. Using the hydraulic formula of Gorlin, a mitral annuloplasty was tailored to the size of each patient so that insufficiency was eliminated without producing hemodynamically significant stenosis. In this group of 11 children there has been one death. The majority of our 11 patients reacquired murmurs of mitral regurgitation. Satisfactory results, however, are not dependent on complete hemodynamic correction. All patients have improved remarkably and have sustained this improvement up to 7 years. These results suggest that mitral annuloplasty should be the operation of choice in children with severe mitral regurgitation.
4267. The National Diet-Heart Study Final Report.
来源: Circulation. 1968年37卷3 Suppl期I1-428页
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