Heart Rate and Systolic Arterial Blood Pressure Variabilities in the Progression of Chronic Heart Failure

Stimulation of endogenous opiate secretion worsens circulatory dysfunction in several forms of shock, in part by inhibiting sympathetic activity. To investigate whether endogenous opiates have a similar effect in chronic heart failure (HF), we measured beta-endorphin concentrations and hemodynamic responses to naloxone infusion (2 mg/kg bolus + 2 mg.kg-1 x h-1) in six control (C) dogs and eight dogs with low-output HF produced by 3 wk of rapid ventricular pacing. The dogs with HF exhibited reduced arterial blood pressure (C, 123 +/- 4 vs. HF, 85 +/- 7 mmHg; P < 0.01) and cardiac outputs (C, 179 +/- 14 vs. HF, 76 +/- 2 ml.min-1 x kg-1; P < 0.01) and elevated plasma norepinephrine concentrations (C, 99 +/- 12 vs. HF, 996 +/- 178 pg/ml; P < 0.01) but normal beta-endorphin concentrations (C, 30 +/- 11 vs. HF, 34 +/- 12 pg/ml; P = NS). Naloxone produced similar transitory increases in blood pressure (C, 14 +/- 5 vs. HF, 26 +/- 25%) and cardiac output (C, 37 +/- 13 vs. HF, 22 +/- 15%) in both groups (both P = NS). No significant changes in norepinephrine concentration or systemic vascular resistance were observed in either group. These findings suggest that beta-endorphin secretion does not exacerbate circulatory dysfunction in chronic heart failure.

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On the actions of noradrenaline, adrenaline and isopropyl noradrenaline on the arterial blood pressure, heart rate and muscle blood flow in man

The Journal of Physiology ◽

10.1113/jphysiol.1949.sp004431 ◽

1949 ◽

Vol 110 (1-2) ◽

pp. 194-204 ◽

Cited By ~ 70

Author(s):

H. Barcroft ◽

H. Konzett

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Blood Flow ◽

Arterial Blood Pressure ◽

Muscle Blood Flow ◽

Arterial Blood

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Terlipressin Versus Norepinephrine to Correct Refractory Arterial Hypotension after General Anesthesia in Patients Chronically Treated with Renin-Angiotensin System Inhibitors

Anesthesiology ◽

10.1097/00000542-200306000-00007 ◽

2003 ◽

Vol 98 (6) ◽

pp. 1338-1344 ◽

Cited By ~ 55

Author(s):

Gilles Boccara ◽

Alexandre Ouattara ◽

Gilles Godet ◽

Eric Dufresne ◽

Michèle Bertrand ◽

...

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Arterial Blood Pressure ◽

Renin Angiotensin System ◽

Arterial Hypotension ◽

Angiotensin System ◽

Renin Angiotensin ◽

Arterial Blood ◽

Long Term Treatment ◽

Systolic Arterial Blood Pressure

Background Terlipressin, a precursor that is metabolized to lysine-vasopressin, has been proposed as a drug for treatment of intraoperative arterial hypotension refractory to ephedrine in patients who have received long-term treatment with renin-angiotensin system inhibitors. The authors compared the effectiveness of terlipressin and norepinephrine to correct hypotension in these patients. Methods Among 42 patients scheduled for elective carotid endarterectomy, 20 had arterial hypotension following general anesthesia that was refractory to ephedrine. These patients were the basis of the study. After randomization, they received either 1 mg intravenous terlipressin (n = 10) or norepinephrine infusion (n = 10). Beat-by-beat recordings of systolic arterial blood pressure and heart rate were stored on a computer. The intraoperative maximum and minimum values of blood pressure and heart rate, and the time spent with systolic arterial blood pressure below 90 mmHg and above 160 mmHg, were used as indices of hemodynamic stability. Data are expressed as median (95% confidence interval). Results Terlipressin and norepinephrine corrected arterial hypotension in all cases. However, time spent with systolic arterial blood pressure below 90 mmHg was less in the terlipressin group (0 s [0-120 s] vs. 510 s [120-1011 s]; P < 0.001). Nonresponse to treatment (defined as three boluses of terlipressin or three changes in norepinephrine infusion) occurred in zero and eight cases (P < 0.05), respectively. Conclusions In patients who received long-term treatment with renin-angiotensin system inhibitors, intraoperative refractory arterial hypotension was corrected with both terlipressin and norepinephrine. However, terlipressin was more rapidly effective for maintaining normal systolic arterial blood pressure during general anesthesia.

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Changes of arterial blood pressure and heart rate in the ox (Bos taurus) with changes of body temperature

The Journal of Physiology ◽

10.1113/jphysiol.1963.sp007219 ◽

1963 ◽

Vol 168 (4) ◽

pp. 736-746 ◽

Cited By ~ 12

Author(s):

D. L. Ingram ◽

G. C. Whittow

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Body Temperature ◽

Arterial Blood Pressure ◽

Bos Taurus ◽

Arterial Blood

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Effects of l-arginine on systemic and renal haemodynamics in conscious dogs

Clinical Science ◽

10.1042/cs0810727 ◽

1991 ◽

Vol 81 (6) ◽

pp. 727-732 ◽

Cited By ~ 18

Author(s):

Marohito Murakami ◽

Hiromichi Suzuki ◽

Atsuhiro Ichihara ◽

Mareo Naitoh ◽

Hidetomo Nakamoto ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Blood Flow ◽

Renal Blood Flow ◽

Arterial Blood Pressure ◽

Mean Arterial Blood Pressure ◽

Renal Haemodynamics ◽

Conscious Dogs ◽

Arginine Infusion ◽

Arterial Blood

1. The effects of l-arginine on systemic and renal haemodynamics were investigated in conscious dogs. l-Arginine was administered intravenously at doses of 15 and 75 μmol min−1 kg−1 for 20 min. 2. Mean arterial blood pressure, heart rate and cardiac output were not changed significantly by l-arginine infusion. However, l-arginine infusion induced a significant elevation of renal blood flow from 50 ± 3 to 94 ± 12 ml/min (means ± sem, P < 0.01). 3. Simultaneous infusion of NG-monomethyl-l-arginine (0.5 μmol min−1 kg−1) significantly inhibited the increase in renal blood flow produced by l-arginine (15 μmol min−1 kg−1) without significant changes in mean arterial blood pressure or heart rate. 4. Pretreatment with atropine completely inhibited the l-arginine-induced increase in renal blood flow, whereas pretreatment with indomethacin attenuated it (63 ± 4 versus 82 ± 10 ml/min, P < 0.05). 5. A continuous infusion of l-arginine increased renal blood flow in the intact kidney (55 ± 3 versus 85 ± 9 ml/min, P < 0.05), but not in the contralateral denervated kidney (58 ± 3 versus 56 ± 4 ml/min, P > 0.05). 6. These results suggest that intravenously administered l-arginine produces an elevation of renal blood flow, which may be mediated by facilitation of endogenous acetylcholine-induced release of endothelium-derived relaxing factor and vasodilatory prostaglandins.

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