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.
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References
Antman E et al (1980) Beneficial effects of nitravenous nitroglycerine in a case of prinzmetal angina. Br Heart J 43:88
Branthwaite MA (1968) Measurement of cardiac output by thermal dilution in man. J Appl Physiol 24:434
Bussman WD et al (1978) Effect of sublingual nitroglycerine in emergency therapy of severe pulmonary oedema. Am J Cardiol 41:931
Bussman WD (1977) Random study on the effect of intravenous nitroglycerine on CK and CK-MB infarct size. Circulation (Suppl 3) 56:65
Capurro NL (1977) Comparison of nitroglycerin, nitroprusside, and phentolamine-induced changes in coronary collateral function in dogs. J Clin Invest 60:295
Chiariello M (1976) Comparison between the effects of nitroprusside and nitroglycerine on ischaemic injury during acute myocardial infarction. Circulation 54:766
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
Epstein SE (1975) Reduction in ischaemic injury by nitroglycerine during acute myocardial infarction. N Engl J Med 292:29
Fahmy NR (1978) Nitroglycerin as a hypotensive drug during general anaesthesia. Anaesthesia 49:17
Flaherty JT (1975) Intravenous nitroglycerine in acute myocardial infarction. Circulation 51:132
Flaherty JT (1976) Effect of intravenous nitroglycerin on left ventricular function and ST segment changes in acute myocardial infarction. Br Heart J 38:612
Gaynon RM (1980) Haemodynamic effects of dobutamine and intravenous nitroglycerine in congestive heart failure. Chest 78:694
Hill NS (1981) Intravenous nitroglycerine, a review of pharmacology, indications, therapeutic effects and complications. Chest 79:69
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
Kaplan JA (1976) Nitroglycerin infusion during coronary artery surgery. Anaesthesia 45:14
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
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
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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
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DOI: https://doi.org/10.1007/BF00265803