Skip to main content
Log in

The haemodynamic responses to incremental doses of intravenous nitroglycerin in left ventricular failure

  • Original Articles
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Summary

The effects of incremental dose infusions of nitroglycerin, 10–160 μg/min, on pulmonary capillary wedge pressure and other haemodynamic variables have been studied in patients with left ventricular failure. Intravenous (IV) nitroglycerin caused a dose-related improvement in myocardial performance, with significant reductions in the raised pulmonary capillary wedge pressure and systemic vascular resistance. At the lowest dose of infusion only the venodilator action of nitroglycerin was apparent. From 40–160 μg/min the associated arteriolar dilatation was associated with a consistent improvement in myocardial performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Antman E et al (1980) Beneficial effects of nitravenous nitroglycerine in a case of prinzmetal angina. Br Heart J 43:88

    CAS  PubMed  Google Scholar 

  2. Branthwaite MA (1968) Measurement of cardiac output by thermal dilution in man. J Appl Physiol 24:434

    CAS  PubMed  Google Scholar 

  3. Bussman WD et al (1978) Effect of sublingual nitroglycerine in emergency therapy of severe pulmonary oedema. Am J Cardiol 41:931

    Google Scholar 

  4. Bussman WD (1977) Random study on the effect of intravenous nitroglycerine on CK and CK-MB infarct size. Circulation (Suppl 3) 56:65

    Google Scholar 

  5. Capurro NL (1977) Comparison of nitroglycerin, nitroprusside, and phentolamine-induced changes in coronary collateral function in dogs. J Clin Invest 60:295

    CAS  PubMed  Google Scholar 

  6. Chiariello M (1976) Comparison between the effects of nitroprusside and nitroglycerine on ischaemic injury during acute myocardial infarction. Circulation 54:766

    CAS  PubMed  Google Scholar 

  7. Come PC (1975) Reversal by phenylephrine on the beneficial effects of intravenous nitroglycerin in patients with acute myocardial infarction. N Engl J Med 293:1003

    CAS  PubMed  Google Scholar 

  8. Epstein SE (1975) Reduction in ischaemic injury by nitroglycerine during acute myocardial infarction. N Engl J Med 292:29

    CAS  PubMed  Google Scholar 

  9. Fahmy NR (1978) Nitroglycerin as a hypotensive drug during general anaesthesia. Anaesthesia 49:17

    CAS  Google Scholar 

  10. Flaherty JT (1975) Intravenous nitroglycerine in acute myocardial infarction. Circulation 51:132

    CAS  PubMed  Google Scholar 

  11. Flaherty JT (1976) Effect of intravenous nitroglycerin on left ventricular function and ST segment changes in acute myocardial infarction. Br Heart J 38:612

    CAS  PubMed  Google Scholar 

  12. Gaynon RM (1980) Haemodynamic effects of dobutamine and intravenous nitroglycerine in congestive heart failure. Chest 78:694

    Google Scholar 

  13. Hill NS (1981) Intravenous nitroglycerine, a review of pharmacology, indications, therapeutic effects and complications. Chest 79:69

    CAS  PubMed  Google Scholar 

  14. Johnson AD (1978) Variant angina pectoris: clinical presentations, coronary angiographic patterns, and the results of medical and surgical treatment in 42 consecutive patients. Chest 734:786

    Google Scholar 

  15. Kaplan JA (1976) Nitroglycerin infusion during coronary artery surgery. Anaesthesia 45:14

    CAS  Google Scholar 

  16. Leier CV (1981) Central and regional haemodynamic effects of intravenous nitroglycerin isosorbide dinitrate, and nitroprusside in patients with congestive heart failure. Am J Cardiol 48:1115

    Article  CAS  PubMed  Google Scholar 

  17. Swan HJC (1970) Catheterization of the heart in man with the use of a flow-directed balloon-tipped catheter. N Engl J Med 283:447

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bayley, S., Valentine, H. & Bennett, E.D. The haemodynamic responses to incremental doses of intravenous nitroglycerin in left ventricular failure. Intensive Care Med 10, 139–145 (1984). https://doi.org/10.1007/BF00265803

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00265803

Key words

Navigation