Key result
Nitroglycerin alters hemodynamics and cardiac work during supine intracardiac monitoring in angina pectoris.
Why the study?
Sublingual nitroglycerin is unlikely to widen narrowed, calcific coronary arteries or increase myocardial blood flow in coronary heart disease, suggesting it relieves angina pectoris by reducing cardiac work through peripheral effects. Intracardiac pressure measurements in the supine position were needed to calculate cardiac work while minimizing orthostatic effects.
Does acute administration of nitroglycerin reduce cardiac work and alter intracardiac pressures in male patients with classical angina pectoris and coronary heart disease?
Does acute administration of nitroglycerin reduce cardiac work and alter intracardiac pressures in male patients with classical angina pectoris and coronary heart disease?
This study investigates the acute hemodynamic effects of nitroglycerin on intracardiac pressures and cardiac work in the supine position among 18 men with angina pectoris and angiographic coronary heart disease.
Answers are grounded in this paper and cite their sources.
Questions reliance on coronary widening for nitroglycerin efficacy in angina; leaves open alternative mechanisms requiring prospective validation.
Nitroglycerin 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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Arborelius et al. (1968) studied Angina pectoris and coronary heart disease (n=18). Nitroglycerin was evaluated on Intracardiac pressure measurements and calculations of cardiac work in the supine position. Nitroglycerin was evaluated in 18 male patients (aged 42-64) with angina pectoris using supine intracardiac pressure measurements to calculate cardiac work; results were truncated in the abstract.
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