Use of ultrasonic and microsphere techniques to evaluate regional aspects of vasodilator therapy in myocardial ischaemia, arterial hypertension and heart failure


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Abstract

Purpose:To review regional aspects of vasodilator therapy in myocardial ischaemia, arterial hypertension and heart failure.Data identification:Results were obtained from experiments (1) performed either in experimental animals or in human volunteers or patients; (2) using either ultrasonic or microsphere techniques; (3) on the effects of different drug classes, including angiotensin converting enzyme inhibitors, calcium antagonists, potassium channel openers and nitrates; and (4) on the arterial and arteriolar vasodilating effects of different drug classes.Conclusions:The regional vasodilator effects, both arteriolar and arterial, of the major classes of drugs used in the treatment of coronary insufficiency, arterial hypertension and cardiac failure appear to be heterogeneous. This heterogeneity is seen with a given drug in different vascular beds; within a class of drugs in a single vascular region; and between the regional vasodilator profiles of different classes of drugs. From the clinical point of view, the consequences of this heterogeneous vasodilation may be either positive (increase in flow, favourable redistribution of flow) or negative (steal phenomenon, opening of shunts).

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