JAY BROWN, M.D.; MARY ROMAN, M.D.
To the editor: The article by Rubin and associates (1) on the hemodynamic effects of nifedipine in primary pulmonary hypertension raises the question of how best to assess pulmonary vasodilation in response to drug therapy (2).
In eight of the nine patients reported by Rubin and associates, the administration of sublingual nifedipine elicited a decrease in calculated pulmonary resistance. All of these patients had an augmentation in cardiac output. Yet in five of the patients, the pulmonary artery diastolic and mean pressures, as well as the diastolic gradient, remained unchanged. How can resistance to flow across the pulmonary bed be
BROWN J, ROMAN M. Nifedipine and Pulmonary Hypertension. Ann Intern Med. ;100:314–315. doi: 10.7326/0003-4819-100-2-314_2
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Published: Ann Intern Med. 1984;100(2):314-315.
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