Elsevier

The Lancet

Volume 344, Issue 8919, 6 August 1994, Pages 371-373
The Lancet

Short reports
Enhanced basal nitric oxide production in heart failure: another failed counter-regulatory vasodilator mechanism?

https://doi.org/10.1016/S0140-6736(94)91402-8Get rights and content

Abstract

Endothelial dysfunction in heart failure could impair nitric oxide production and lead to increased vascular resistance. If endogenous production of nitric oxide is reduced, NG- monomethyl-L-arginine (L-NMMA), an inhibitor of such production, should have a diminished vasoconstrictor effect. We administered L-NMMA to 12 patients being investigated for heart failure. L-NMMA increased median pulmonary and systemic vascular resistances by 61 (range - 3 to 240) and 430 (63 to 1609)dynes s cm-5, respectively (p<0·03 and p<0·005). Arterial pressures also increased. Median cardiac output fell by 0·6 (0 to - 2·3) L per min (p<0·005). These data suggest that vascular nitric oxide may be another example of a failed counter-regulatory vasodilator system in heart failure.

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