The haemodynamic effects of losartan after right ventricle infarct in young pigs

The effect of an intravenous bolus injection of the type 1 angiotensin II receptor antagonist, losartan on haemodynamics after right heart infarct was studied in an experimental setting. Right heart infarct was induced in twelve young swine and losartan was given in a bolus intravenous dose one hr later to five animals, while seven animals served as controls. Haemodynamics were then followed for one hr at 15 min intervals. Losartan was subsequently shown to decrease central venous pressure and wedge pressure, while cardiac output, left ventricle stroke work and stroke volume all showed improvement. Compared to the control animals, pulmonary vascular resistance, systemic vascular resistance and systemic pressures were unaffected by the drug, as was heart rate. The use of losartan shortly after right heart infarct reduced both right and left heart preload as well as inducing an improvement in cardiac performance. At the same time, systemic pressures and heart rate were maintained. We conclude that an inhibition of angiotensin II action may be a benefit in the treatment of right heart failure symptoms during the first hours after right heart infarct.