Hemodynamic effects of aminophylline in cor pulmonale.

AMINOPHYLLINE (theophylline ethylenediamine) has been used traditionally in the treatment of bronchospasm associated with asthma, obstructive bronchitis, and emphysema, and its effect on reducing airway obstruction has been clearly shown.' The hemodynamic effects of this agent, however, have not been fully explored. Aminophylline has been shown to reduce the pulmonary artery pressure in patients with cor pulmonale, a change considered to be secondary to pulmonary arteriolar dilatation.2 In a previous study3 in patients with left ventricular failure, aminophylline was found to reduce the filling pressures of both ventricles and to lower pulmonary artery pressure with a concomitant increase in cardiac output. No studies have assessed the simultaneous changes in right and left heart pressures in cor pulmonale that occur during an infusion of aminophylline. This study was undertaken to provide a more complete evaluation of the hemodynamic effect of aminophylline in patients with chronic obstructive pulmonary disease with cor pulmonale as defined by Harvey and Ferrer,4 that is, "cardiac enlargement or failure in association with a disease process known to attack primarily the lungs or some aspect of the act of breathing and in so doing to compromise right ventricular function."