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Cardiovascular Research 1999 43(3):628-638; doi:10.1016/S0008-6363(99)00114-5
© 1999 by European Society of Cardiology
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Copyright © 1999, European Society of Cardiology

Inhaled nitric oxide in cardiology practice

Christopher S Haywarda,*, Raymond P Kellyb and Peter S Macdonaldb

aDepartment of Cardiac Medicine, National Heart and Lung Institute, Imperial College School of Medicine, London SW3 6LY, UK
bCardiology Department, St Vincent’s Hospital, Darlinghurst, NSW, 2010 Australia

* Corresponding author. Tel.: +44-171-351-8631; fax: +44-171-823-3392 c.s.hayward{at}ic.ac.uk

Inhaled nitric oxide allows selective pulmonary vasodilatation with rapidity of action. It is effective in the acute post-operative management of pulmonary hypertension in cardiac surgical patients and is also valuable in assessing the pulmonary vasodilator capacity in patients with chronic pulmonary hypertension. This review examines the current role of inhaled nitric oxide in cardiac medicine, discussing issues concerning its administration and toxicity, as well as a summary of clinical studies in cardiac patients. New roles, as a modifier of platelet and leukocyte function, post-thrombolysis and following lung transplantation are described. New agents and alternative therapies, which prolong pulmonary activity, are also discussed.

KEYWORDS NO, Nitric oxide; INO, Inhaled nitric oxide; ppm, Parts per million, cGMP, Guanosine 3',5'-cyclic monophosphate; GC, Guanylate cyclase; MetHb, Methaemoglobin; NOHb, Nitrosyl-haemoglobin; ARDS, Adult respiratory distress syndrome; PVR, Pulmonary vascular resistance; LVAD, Left ventricular assist device


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