Effects of Piroximone on the Right Ventricular Function in Severe Heart Failure Patients

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 1994 May 1

PMID 7930028

Citations 2

Authors

J P Saal

R Habbal

P Estagnasie

D Lellouche

A CASTAIGNE

J L Dubois-Rande

Affiliations

Soon will be listed here.

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 micrograms/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 micrograms/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 micrograms/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.

Citing Articles

Ishihara S, Gayat E, Sato N, Arrigo M, Laribi S, Legrand M Clin Res Cardiol. 2016; 105(12):971-980.

PMID: 27314418 DOI: 10.1007/s00392-016-1009-6.

Clinical pharmacokinetics of vasodilators. Part II.

Kirsten R, Nelson K, Kirsten D, Heintz B Clin Pharmacokinet. 1998; 35(1):9-36.

PMID: 9673832 DOI: 10.2165/00003088-199835010-00002.

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