Abstract
Rational use of vasodilators to induce afterload reduction is predicated on a thorough knowledge of the constituents of afterload and of the role ventriculoarterial coupling plays in determining their effects. Afterload reduction therapy should be goal directed with the intent to improve stroke volume and tissue oxygen delivery rather than to decrease blood pressure per se. This review will summarize the components comprising circulatory system afterload and will use ventriculoarterial coupling concepts to demonstrate the variable but predictable effects of vasodilator therapy on hemodynamics and tissue oxygen delivery. This article addresses the third of eight topics comprising the special issue entitled “Pharmacologic strategies with afterload reduction in low cardiac output syndrome after pediatric cardiac surgery”.
Keywords: Ventriculoarterial coupling, afterload reduction, vasodilation, ventricular performance, ventricular compliance, ventricular elastance, arterial elastance, oxygen delivery, preload recruitable stroke work.
Graphical Abstract
Current Vascular Pharmacology
Title:Theoretical and Evidence-Based Benefit of Afterload Reduction in the Postoperative Pediatric Heart
Volume: 14 Issue: 1
Author(s): James A. DiNardo and Melvin C. Almodovar
Affiliation:
Keywords: Ventriculoarterial coupling, afterload reduction, vasodilation, ventricular performance, ventricular compliance, ventricular elastance, arterial elastance, oxygen delivery, preload recruitable stroke work.
Abstract: Rational use of vasodilators to induce afterload reduction is predicated on a thorough knowledge of the constituents of afterload and of the role ventriculoarterial coupling plays in determining their effects. Afterload reduction therapy should be goal directed with the intent to improve stroke volume and tissue oxygen delivery rather than to decrease blood pressure per se. This review will summarize the components comprising circulatory system afterload and will use ventriculoarterial coupling concepts to demonstrate the variable but predictable effects of vasodilator therapy on hemodynamics and tissue oxygen delivery. This article addresses the third of eight topics comprising the special issue entitled “Pharmacologic strategies with afterload reduction in low cardiac output syndrome after pediatric cardiac surgery”.
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Cite this article as:
DiNardo A. James and Almodovar C. Melvin, Theoretical and Evidence-Based Benefit of Afterload Reduction in the Postoperative Pediatric Heart, Current Vascular Pharmacology 2016; 14 (1) . https://dx.doi.org/10.2174/1570161113666151014123905
DOI https://dx.doi.org/10.2174/1570161113666151014123905 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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