Document Detail

Effects of nitrate therapy on ventricular remodeling and function.
MedLine Citation:
PMID:  8279353     Owner:  NLM     Status:  MEDLINE    
The hypothesis that nitrates might effectively limit left ventricular remodeling and improve function after acute myocardial infarction has been tested in experimental and clinical models, with special attention to the pathophysiologic evolution of remodeling. In 1 clinical study, before the thrombolytic era, the effects of low-dose intravenous nitroglycerin infusion for the first 48 hours during acute myocardial infarction was evaluated in a prospective, randomized, single-blinded, placebo-controlled study of 310 patients (154 nitroglycerin; 156 placebo). Nitroglycerin proved to be safe and produced several benefits compared with placebo: (1) smaller infarct size; (2) less left ventricular dysfunction; (3) less infarct expansion and thinning; (4) better functional status; (5) fewer in-hospital complications such as left ventricular failure, left ventricular thrombus, cardiogenic shock, and infarct extension; and (6) fewer deaths up to 1 year. Two subsequent clinical studies in the thrombolytic era, with low-dose intravenous nitroglycerin infusion during infarction over the first 48 hours followed by buccal nitrate (eccentric dose regimen) or placebo during healing over 6 weeks postinfarction, indicated that prolonged nitrate therapy effectively limited left ventricular remodeling and improved function further compared with placebo.
B I Jugdutt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-02-04     Completed Date:  1994-02-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  161G-168G     Citation Subset:  AIM; IM    
Department of Medicine, University of Alberta, Edmonton, Canada.
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MeSH Terms
Heart Ventricles / drug effects*,  pathology,  physiopathology
Myocardial Infarction / drug therapy*,  pathology,  physiopathology
Nitrates / pharmacology*,  therapeutic use
Time Factors
Vasodilator Agents / pharmacology*,  therapeutic use
Ventricular Function, Left / drug effects*,  physiology
Reg. No./Substance:
0/Nitrates; 0/Vasodilator Agents

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