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October 3, 1980

The Use of Pressure-Rate Product

Author Affiliations

USA Army Hospital Fort Belvior, Va
Georgetown University Hospital Washington, DC

JAMA. 1980;244(14):1558. doi:10.1001/jama.1980.03310140018012

To the Editor.—  It was recently stated in the article "Hemodynamic Effects of Nitrous Oxide Administered During Cardiac Catheterization" by Wynne and coauthors (243:1440, 1980) that pressure-rate product was a major index of myocardial oxygen demand (MVO2). This statement deserves special consideration in view of recent articles by Sonntag et al1 and Kissin et al2 in Anesthesiology. Poor correlation between myocardial oxygen consumption and heart rate-blood pressure (BP) product index was found during halothane anesthesia in man. The seemingly logical inference that pressure-rate product not only is an index of MVO2 but also a predictor of possible myocardial ischemia should not be made.Wynne et al in their concluding paragraph state that nitrous oxide and oxygen mixture may be a safe agent, particularly in patients with ischemic heart disease principally because of decreases in heart rate and cardiac output. The problem of pressure-rate product serving as a