Bronchial hyperresponsiveness to methacholine in patients with impaired left ventricular function

Article Abstract:

Patients who have failure of the left side of the heart (congestive heart failure) commonly have nighttime attacks of wheezing (cardiac asthma). Obstruction and narrowing of airways associated with cardiac asthma may be caused by swelling and thickening of the walls of bronchial passages. The altered blood flow, caused by heart failure, increases the blood pressure in the bronchial area, compromising the movement of blood away from the bronchial tubes and intensifying the swelling. The thickening of the bronchial wall prevents inhalants from being an effective treatment for cardiac asthma. The bronchial tubes and bronchial vessels do not react uniformly to administered drugs. Acetylcholine is a cholinergic drug known to constrict bronchial tubes, and dilate bronchial blood vessels. Alpha-adrenergic agonists are drugs that constrict the blood vessels supplying the bronchial tubes. The effects of these two chemicals on bronchial tubes and blood vessels were evaluated in 23 patients with congestive heart failure who were given methacholine, a drug similar to acetylcholine, with and without pretreatment with alpha-adrenergic agonists. An increased bronchial responsiveness to methacholine was found in 21 of the patients with impaired heart function. There was no bronchial reaction in 9 out of 10 healthy patients when the cholinergic agent was administered. In 43 percent of the patients having methacholine-induced bronchial obstruction, bronchodilator drugs reversed the effect. Pretreatment with alpha-adrenergic agonists prevented the unwanted effects of methacholine in 12 patients.

Complications and side effects, Development and progression, Bronchial spasm, Congestive heart failure, Methacholine

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Improvement in exercise performance by inhalation of methoxamine in patients with impaired left ventricular function

Article Abstract:

Treatment with inhaled methoxamine may improve the ability of patients with impaired heart function to exercise. Of 19 patients with impaired heart function, 10 underwent a treadmill exercise test to measure exercise endurance, and nine underwent a graded treadmill test to measure maximum exercise capacity. Patients were tested after treatment with 10 milligrams of inhaled methoxamine, or a placebo, an inactive substance. Among patients who underwent endurance testing, treatment with methoxamine increased endurance from an average of 5 minutes to an average of 10 minutes. Of those who underwent testing of maximum exercise capacity, treatment with methoxamine increased exercise time from an average of nine minutes to almost 10 minutes. Treatment with methoxamine increased maximum oxygen consumption from an average of 18.5 milliliters (ml) per minute per milligram of body weight to an average of 20 milliliters per minute per kilogram of body weight.

Health aspects, Heart diseases, Sympathomimetic agents

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Immediate coronary angiography in survivors of out-of-hospital cardiac arrest

Article Abstract:

Patients who are admitted to a hospital in cardiac arrest should receive angioplasty if angiography reveals they have an obstructed coronary artery. Angioplasty is a technique that opens clogged arteries. Researchers performed angiography on 84 patients admitted with symptoms of cardiac arrest. Angiography is an imaging technique. Forty (48%) had an obstruction in a coronary artery that may have caused their symptoms. Twenty-eight were successfully treated with angioplasty. Fourteen of these survived with few complications. The overall survival rate among the 84 patients was 38%.

Care and treatment, Usage, Evaluation, Angiography, Transluminal angioplasty, Balloon angioplasty, Cardiac arrest

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