Document Detail


Hemodynamic and hormonal effects of high-dose transdermal nitroglycerin in patients with chronic congestive heart failure.
MedLine Citation:
PMID:  3929585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hemodynamic effect of a large dose of nitroglycerin (NTG) (90 mg) given transdermally using a reservoir system was studied in 10 patients with severe, long-standing congestive heart failure. Serial hemodynamic measurements over 24 hours revealed a mild decrease in mean pulmonary artery wedge pressure. However, the change from baseline was significant only at 2 hours (19 +/- 9 vs 27 +/- 6 mm Hg). Mean right atrial pressure fell 1 hour after initiation of therapy, from 12 +/- 7 to 8 +/- 5 mm Hg. However, the change from control was not statistically significant. No significant changes were noted in heart rate, mean blood pressure, cardiac index, and systemic and pulmonary vascular resistance. Individual analysis of the effect of transdermal NTG on pulmonary artery wedge pressure demonstrated at 20% or greater reduction in 8 of 10 patients. However, persistent effect (longer than 8 hours) was seen in only 4 patients. Removal of NTG patches at 24 hours did not result in hemodynamic rebound. Serum catecholamine levels and renin concentration did not change 2 hours and 24 hours after initiation of NTG therapy or after removal of NTG patches. Thus, a large dose (90 mg) of transdermal NTG using a reservoir system results in mild and mostly statistically insignificant hemodynamic effect in patients with chronic severe congestive heart failure. Although a reduction in pulmonary artery wedge pressure is seen in most patients, rapid attenuation of this response is found in many patients and the effect only rarely lasts for 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
U Elkayam; A Roth; B Henriquez; L Weber; D Tonnemacher; S H Rahimtoola
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  56     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-10-22     Completed Date:  1985-10-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  555-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adult
Blood Pressure / drug effects
Cardiac Output / drug effects
Catecholamines / blood*
Female
Heart Failure / drug therapy*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Nitroglycerin / administration & dosage*,  therapeutic use
Pulmonary Wedge Pressure / drug effects
Renin / blood*
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Catecholamines; 55-63-0/Nitroglycerin; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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