Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jul;68(1):23-33.
doi: 10.1111/j.1365-2125.2009.03434.x.

Non-invasive measurement of the haemodynamic effects of inhaled salbutamol, intravenous L-arginine and sublingual nitroglycerin

Anna Tahvanainen  1 , Miia Leskinen, Jenni Koskela, Erkki Ilveskoski, Juha Alanko, Mika Kähönen, Tiit Kööbi, Lauri Lehtimäki, Eeva Moilanen, Jukka Mustonen, Ilkka Pörsti
Affiliations

Non-invasive measurement of the haemodynamic effects of inhaled salbutamol, intravenous L-arginine and sublingual nitroglycerin

Anna Tahvanainen et al. Br J Clin Pharmacol. 2009 Jul.

Abstract

Aims: To examine the effects of salbutamol and L-arginine, two compounds acting largely on the endothelium, and the endothelium-independent agent nitroglycerin on blood pressure, arterial compliance, cardiac function and vascular resistance.

Methods: Continuous radial pulse wave analysis, whole-body impedance cardiography, and plethysmographic blood pressure from fingers in the supine position and during head-up tilt were recorded in nine healthy subjects. Data were captured before and after L-arginine (10 mg mg(-1) min(-1)) or saline infusion, salbutamol (400 microg) or placebo inhalation, and sublingual nitroglycerin (0.25 mg) or placebo resoriblet.

Results: The results of all measurements were comparable before drug administration. The effects of inhaled salbutamol were apparent in the supine position: systemic vascular resistance (-9.2 +/- 2.6%) and augmentation index (-4.0 +/- 1.5%) decreased, and heart rate (8.6 +/- 2.5%) and cardiac output (8.8 +/- 3.1%) increased. L-arginine had no clear effects on supine haemodynamics, but during head-up tilt blood pressure was moderately decreased and reduction in aortic reflection time prevented, indicating improved large arterial compliance. Nitroglycerin reduced supine vascular resistance (-6.7 +/- 1.8%) and augmentation index (-7.4 +/- 1.6%), and increased cardiac output (+9.2 +/- 2.7%). During head-up tilt, nitroglycerin increased cardiac output (+10.6 +/- 5.6%) and heart rate (+40 +/- 7.5%), decreased vascular resistance (-7.8 +/- 5.8%) and augmentation index (-18.7 +/- 3.2%), and prevented the decrease in aortic reflection time.

Conclusions: Inhaled salbutamol predominantly changed supine haemodynamics, whereas the moderate effects of L-arginine were observed during the head-up tilt. In contrast, small doses of nitroglycerin induced major changes in haemodynamics both supine and during the head-up tilt. Altogether, these results emphasize the importance of haemodynamic measurements in both the supine and upright positions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean values for aortic mean arterial pressure (a–c), cardiac output (d–f) and systemic vascular resistance index (SVRI) (g–i) after L-arginine infusion (10 mg kg−1 min−1), saline infusion, salbutamol inhalation (400 µg), placebo inhalation, nitroglycerin resoriblet (0.25 mg) and placebo resoriblet. Research drug was administrated at measurement time 0 and head-up tilt was performed from 5 to 10 min. *P < 0.05 vs. saline/placebo, anova
Figure 2
Figure 2
Mean values for heart rate (a–c), augmentation index (d–f) and aortic reflection time (g–i) after L-arginine infusion (10 mg kg−1 min−1), saline infusion, salbutamol inhalation (400 µg), placebo inhalation, nitroglycerin resoriblet (0.25 mg) and placebo resoriblet. Research drug was administrated at measurement time 0 and head-up tilt was performed from 5 to 10 min. *P < 0.05 vs. saline/placebo, anova
See this image and copyright information in PMC

References

    1. Feletou M, Vanhoutte PM. Endothelium-derived hyperpolarizing factor: where are we now? Arterioscler Thromb Vasc Biol. 2006;26:1215–25. - PubMed
    1. Landmesser U, Hornig B, Drexler H. Endothelial function: a critical determinant in atherosclerosis? Circulation. 2004;109(21) Suppl. 1:II27–33. - PubMed
    1. Rumbaut RE, Slaff DW, Burns AR. Microvascular thrombosis models in venules and arterioles in vivo. Microcirculation. 2005;12:259–74. - PubMed
    1. Rabasseda X. New joint European Hypertension/European Society of Society of Cardiology guidelines for the management of arterial hypertension. Timely Top Med Cardiovasc Dis. 2007;11:E18. - PubMed
    1. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen L, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgozoglu L, Wiklund O, Zampelas A. European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) Eur J Cardiovasc Prev Rehabil. 2007;14(Suppl. 2):S1–113. - PubMed

Publication types

MeSH terms