Document Detail


Absence of hemodynamic tolerance to nicorandil in patients with severe congestive heart failure.
MedLine Citation:
PMID:  8154425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T Tsutamoto; M Kinoshita; I Nakae; Y Maeda; A Wada; T Yabe; H Horie
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  127     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-05-12     Completed Date:  1994-05-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  866-73     Citation Subset:  AIM; IM    
Affiliation:
First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
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MeSH Terms
Descriptor/Qualifier:
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:
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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