| Absence of hemodynamic tolerance to nicorandil in patients with severe congestive heart failure. | |
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MedLine Citation:
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PMID: 8154425 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To evaluate whether hemodynamic tolerance develops to nicorandil, a nitrate and potassium channel opener, 14 patients with chronic heart failure (CHF) were treated with nicorandil and 11 were treated with nitroglycerin (GTN). Doses of GTN or nicorandil were titrated to achieve a > or = 20% reduction in pulmonary capillary wedge pressure (PCWP) within 1 hour, and the infusion was maintained at a constant rate for 24 hours. Both groups of patients had comparable hemodynamic parameters before drug infusions were started. The fall in PCWP was identical after 1 hour infusion of either GTN or nicorandil. In the GTN group, PCWP was not significantly different from the baseline value at 12 hours; however, in the nicorandil group, PCWP remained significantly lower than the preinfusion value for 24 hours. During the study period changes in plasma atrial natriuretic peptide (ANP) concentrations paralleled and correlated with changes in PCWP (r = 0.84, p < 0.001). These findings indicate that CHF patients develop hemodynamic tolerance to GTN within 12 hours of continuous infusion, but not to nicorandil, which remained hemodynamically effective during the 24-hour period of infusion. Furthermore, plasma ANP concentration may be a useful noninvasive index of hemodynamic tolerance during GTN or nicorandil therapy in patients with CHF. |
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Authors:
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T Tsutamoto; M Kinoshita; I Nakae; Y Maeda; A Wada; T Yabe; H Horie |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American heart journal Volume: 127 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1994 Apr |
Date Detail:
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Created Date: 1994-05-12 Completed Date: 1994-05-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 866-73 Citation Subset: AIM; IM |
Affiliation:
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First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Atrial Natriuretic Factor / blood Drug Tolerance Female Heart Failure / blood, drug therapy* Hemodynamics / drug effects* Humans Male Middle Aged Niacinamide / analogs & derivatives*, pharmacology, therapeutic use Nicorandil Nitroglycerin / pharmacology, therapeutic use Pulmonary Wedge Pressure / drug effects Vasodilator Agents / pharmacology, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 55-63-0/Nitroglycerin; 65141-46-0/Nicorandil; 85637-73-6/Atrial Natriuretic Factor; 98-92-0/Niacinamide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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