Predictors of inotropic and chronotropic effects of NG-monomethyl-L-arginine O'Sullivan, Anthony en_US Brillante, D en_US Johnstone, M en_US Howes, L en_US 2021-11-25T14:04:25Z 2021-11-25T14:04:25Z 2009 en_US
dc.description.abstract Background The haemodynamic effects of intravenous infusion of the non-selective nitric oxide synthase (NOS) l-omega monomethyl arginine (l-NMMA) have previously been characterized in humans. Its effect of reducing cardiac index (CI) is an important reason for the increase in mortality in patients with septic shock receiving l-NMMA in a pivotal outcome trial for this indication. The mechanism for the reduction in CI however, is uncertain. Methods In this study, we investigated the haemodynamic and arterial stiffness response to a bolus intravenous infusion of l-NMMA (3 mg kg−1 over 5 min) in 26 healthy human volunteers to clarify the likely cause of l-NMMA induced negative inotropic and chronotropic effects. Digital photoplethysmography (MicroMedical Pulse Trace) was used to derive two measures of arterial stiffness: stiffness index, a measure of large arterial stiffness, and reflection index (RI), a measure of small- to medium-sized arterial stiffness. Haemodynamic measurements of systolic blood pressure, diastolic blood pressure, heart rate, systemic vascular resistance index (SVRI), stroke index and CI were made using a bioimpedance monitor (BioZ Cardiodynamics). Results We found that changes in CI during l-NMMA are closely related to changes in RI and SVRI. Conclusion The negative inotropic effect of l-NMMA may be a result of an increase in coronary vascular resistance and a resultant decrease in myocardial perfusion. The reduction in CI may also result from a direct reduction of the normal positive inotropic effect of NO by l-NMMA which is closely correlated with its effects on SVRI. en_US
dc.identifier.issn 0014-2972 en_US
dc.language English
dc.language.iso EN en_US
dc.rights CC BY-NC-ND 3.0 en_US
dc.rights.uri en_US
dc.source Legacy MARC en_US
dc.title Predictors of inotropic and chronotropic effects of NG-monomethyl-L-arginine en_US
dc.type Journal Article en
dcterms.accessRights metadata only access
dspace.entity.type Publication en_US
unsw.description.publisherStatement The definitive version is available at en_US
unsw.identifier.doiPublisher en_US
unsw.relation.faculty Medicine & Health
unsw.relation.faculty Other UNSW
unsw.relation.ispartofjournal European Journal of Clinical Investigation en_US
unsw.relation.ispartofpagefrompageto 273-279 en_US
unsw.relation.ispartofvolume 39 en_US
unsw.relation.originalPublicationAffiliation O'Sullivan, Anthony, Clinical School - St George Hospital, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Brillante, D, UNSW en_US
unsw.relation.originalPublicationAffiliation Johnstone, M en_US
unsw.relation.originalPublicationAffiliation Howes, L en_US Clinical School St George Hospital *
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