Sustained salutary effects of oral controlled‐release nitroglycerin on ventricular function in congestive heart failure
Why the study?
Does oral controlled-release nitroglycerin improve hemodynamic parameters in patients with left ventricular failure?
Population
10 patients with left ventricular failure
Design
Case_series
Follow-up
4 hours
Authors
Discussion
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Member takes
Implication
May support hemodynamic effects of oral nitroglycerin in LV failure; hypothesis-generating and requires randomized confirmation before practice change.
Key Points
- Determine the hemodynamic effects and duration of action of an oral controlled-release nitroglycerin formulation in patients with left ventricular failure.
- Administered oral controlled-release nitroglycerin at doses ranging from 6.5 mg to 19.5 mg to 10 patients with left ventricular failure.
- Assessed hemodynamic parameters continuously over a 4-hour period following drug administration.
- Left ventricular filling pressure decreased significantly from 23 to 17 mm Hg at 20 minutes (p < 0.01), reached a minimum of 15 mm Hg at 1 hour (p < 0.001), and remained significantly reduced across 4 hours (p < 0.02).
- In 4 patients with persistently elevated filling pressure (29 to 23 mm Hg, p < 0.05), cardiac index increased from 1.7 to 2.1 l/min/m² (p < 0.01) and peripheral vascular resistance dropped from 2074 to 1571 dyne·s·cm⁻⁵ (p < 0.02).
- In 6 patients whose filling pressure dropped to 12 mm Hg or less (18 to 10 mm Hg, p < 0.005), cardiac index and peripheral vascular resistance exhibited no significant changes (p > 0.05).
Structured PICO
Does oral controlled-release nitroglycerin improve hemodynamic parameters in patients with left ventricular failure?
P
Population
10 patients with left ventricular failure
I
Intervention
Oral controlled-release nitroglycerin 6.5 mg to 19.5 mg
O
Outcome
Hemodynamic effects including left ventricular filling pressure over a 4-hour periodsurrogate
Oral controlled-release nitroglycerin provides sustained reductions in left ventricular filling pressure in patients with congestive heart failure.
Cite This Study
Amsterdam et al. (1979) studied this question.