Acute effect of nitroglycerin on haemodynamics of angina pectoris.
1968; BMJ; Volume: 30; Issue: 3 Linguagem: Inglês
10.1136/hrt.30.3.407
ISSN1468-201X
AutoresM Arborelius, H. Lecerof, Annika Malm, Robert O. Malmborg,
Tópico(s)Cardiovascular Function and Risk Factors
ResumoNitroglycerin is regarded as a "coronary vasodila- tor", but it is unlikely that, given sublingually, this drug could widen narrowed and calcific main branches of coronary arteries.Furthermore, no studies to date have shown any significant increase in myocardial blood flow in patients with diseased coronary arteries (Gorlin et al., 1959; Bing et al., 1964; Bernstein et al., 1966).Nitroglycerin has a decided effect on the arteriolar and venous beds of normal subjects, by reducing systemic arterial blood pressure, lowering vascular resistance, and decreasing venous tone (Mason and Braunwald, 1965).Similar effects have also been demonstrated in patients with coronary heart disease studied during continuous exercise in the sitting position (Christensson et al., 1965).These peri- pheral effects reduced cardiac output and stroke volume, and angina pectoris disappeared.The authors suggest that nitroglycerin may relieve angina pectoris by reducing the work of the heart.The present study with intracardiac pressure measurements was carried out on patients in the supine position to allow for calculations of cardiac work and to minimize orthostatic effects. SUBJECTS AND METHODSStudies were made of 18 male patients between 42 and 64 years of age; all had a history of classical angina pectoris and electrocardiographic and angiographic evidence of coronary heart disease.The studies were done as part of a thorough evaluation of their cardiac
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