Angiotensin II: A Multimodal Approach to Vasoplegia in a Cardiac Setting

	PATIENT ONE	PATIENT TWO
Age (years)	59	44
Gender	Male	Male
Race	Caucasian	African American
Primary acute illness	Primary graft dysfunction	Right heart failure post left ventricular assist device
MAP initiation for ANG2 (mm Hg)	56	45
Duration of ANG2 (hours)	24	60
Peak dose of ANG2 (ng/kg/min)	20	30
Patient outcome	Discharged to rehab facility	Discharged home, subsequent orthotopic heart transplantation

Table 2

Hemodynamic parameters pre- and post-initiation of angiotensin II (ANG2). MAP: mean arterial pressure; RA: right atrium; PA: pulmonary artery; PCWP: pulmonary capillary wedge pressure; SVR: systemic vascular resistance; CI: cardiac index; NED: norepinephrine equivalent dose

	MAP	RA	PA	PCWP	SVR	CI	NED
Immediately pre-initiation of ANG2
Patient one	56 mm Hg	14 mm Hg	24/17 mm Hg	14 mm Hg	542 (dyne*sec)/cm⁵	3.10	0.35
Patient two	45 mm Hg	20 mm Hg	61/31 mm Hg	27 mm Hg	319 (dyne*sec)/cm⁵	2.88	0.3
~12 hours post-initiation of ANG2
Patient one	85 mm Hg	8 mm Hg	40/18 mm Hg	15 mm Hg	1185 (dyne*sec)/cm⁵	2.6	0.105
Patient two	65 mm Hg	6 mm Hg	54/17 mm Hg	16 mm Hg	875 (dyne*sec)/cm⁵	2.5	0.1

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DOI: https://doi.org/10.14797/mdcvj.576 | Journal eISSN: 1947-6108

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Language: English

Page range: 28 - 31

Submitted on: Aug 28, 2021

Accepted on: Oct 1, 2021

Published on: Nov 3, 2021

Published by: Houston Methodist DeBakey Heart & Vascular Center

In partnership with: Paradigm Publishing Services

Keywords:

Angiotensin II,

shock,

heart failure,

vasoplegia

© 2021 William Sovic, Christo Mathew, Britton Blough, Kara-Ann Monday, Teena Sam, Hira Zafar, Cesar Guerrero-Miranda, Melody Sherwood, Christopher Hebert, Shelley Hall, Amit Alam, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

Volume 17 (2021): Issue 3