Key result
Sublingual nitroglycerin reduces ascending aortic systolic pressure by ~22 mmHg, surpassing brachial reduction.
Why the study?
The effect of nitroglycerin on left ventricular afterload is not accurately reflected by pressure measurements in peripheral arteries such as the brachial artery.
Does sublingual nitroglycerin reduce left ventricular afterload more than what is apparent from brachial artery pressure measurements in patients undergoing cardiac catheterization?
Population
14 patients undergoing cardiac catheterization
Comparison
Ascending aortic pressure vs brachial artery pressure before and after nitroglycerin
Design
Case series with invasive pressure wave comparison
Follow-up
Immediate during cardiac catheterization
Authors
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Brachial pressure may underestimate nitroglycerin afterload reduction; hypothesis-generating case observation requiring prospective central-pressure trials.
Does sublingual nitroglycerin reduce left ventricular afterload more than what is apparent from brachial artery pressure measurements in patients undergoing cardiac catheterization?
Nitroglycerin reduces left ventricular afterload through arterial dilation more significantly than what is reflected by peripheral (brachial) artery pressure measurements.
Kelly et al. (1990) studied undergoing cardiac catheterization (n=14). Nitroglycerin vs. baseline was evaluated on Change in ascending aortic and brachial systolic pressure. Sublingual nitroglycerin (0.3 mg) reduced ascending aortic systolic pressure by an average of 22 mmHg, compared to an average fall of 12 mmHg in the brachial artery.