What question did this study set out to answer?

To evaluate whether early intravenous nitroglycerin infusion decreases the extent of left ventricular asynergy in patients experiencing an acute myocardial infarction.

December 1, 1983Circulation

Persistent reduction in left ventricular asynergy in patients with acute myocardial infarction by intravenous infusion of nitroglycerin.

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Why the study?

Does intravenous nitroglycerin infusion reduce left ventricular asynergy in patients with a first anterior acute myocardial infarction?

Population

22 patients with a first anterior acute myocardial infarction (AMI)

Comparison

Intravenous nitroglycerin infusion initiated… vs Intravenous infusion of 5% dextrose in water

Design

RCT, Patients were randomized

Follow-up

10 days

Authors

BJBodh I. JugduttUniversity of Alberta BSBruce SussexHeart Failure / Cardiomyopathy JWJ. Wayne WarnicaHeart Failure / Cardiomyopathy

Discussion

Member takes

Implication

Supports early IV nitroglycerin in first anterior MI to limit LV asynergy; confirms benefit on post-MI ventricular function in this RCT.

Key Points

To evaluate whether early intravenous nitroglycerin infusion decreases the extent of left ventricular asynergy in patients experiencing an acute myocardial infarction.
Randomized trial of 22 patients presenting within 5.6 hours of a first anterior acute myocardial infarction, assigned to intravenous nitroglycerin (n=11) or 5% dextrose control (n=11).
Nitroglycerin infusions were titrated to lower mean arterial pressure by an average of 7% (maintaining above 80 mm Hg) for 39 hours.
Two-dimensional echocardiography measured asynergic segments across four short-axis levels before treatment, at 1 hour, and at 10 days.
Total left ventricular asynergy decreased from 25% at baseline to 12% at 1 hour and 9% at 10 days in the nitroglycerin group (p < .001), while remaining unchanged in controls (25% at baseline, 25% at 1 hour, and 24% at 10 days).
Nitroglycerin significantly lowered left ventricular filling pressure (p < .005), reduced precordial ST-segment elevation (p < .001), and decreased computed creatine kinase infarct size (p < .05), with no changes observed in the control group.

Structured PICO

Does intravenous nitroglycerin infusion reduce left ventricular asynergy in patients with a first anterior acute myocardial infarction?

Population

22 patients with a first anterior acute myocardial infarction (AMI)

Intervention

Intravenous nitroglycerin (NG) infusion initiated within 5.6 hours after the onset of pain, titrated to lower mean arterial pressure to an average level of 7% below control (but not below 80 mm Hg) and maintained for 39 hours

Comparator

Intravenous infusion of 5% dextrose in water

Outcome

Extent of left ventricular asynergy (akinesis and/or dyskinesis) measured by two-dimensional echocardiography at 1 hour and 10 dayssurrogate

Early intravenous nitroglycerin infusion in patients with a first anterior acute myocardial infarction persistently reduces left ventricular asynergy and infarct size.

Cite This Study

Jugdutt et al. (1983) studied this question.

synapsesocial.com/papers/6a73e44b0e7fa2a8810dd8ce https://doi.org/10.1161/01.cir.68.6.1264

Topics

Echocardiography

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Persistent reduction in left ventricular asynergy in patients with acute myocardial infarction by intravenous infusion of nitroglycerin.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Persistent reduction in left ventricular asynergy in patients with acute myocardial infarction by intravenous infusion of nitroglycerin.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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