Hemodynamic effects of topical, oral and sublingual nitroglycerin in left ventricular failure

J. A. Franciosa, R. C. Blank, Jay N Cohn, E. Mikulic

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Long-acting nitroglycerin might be useful for chronic vasodilator therapy. Hemodynamics were observed after 0.6 mg of nitroglycerin sublingually, 13 mg orally, and 33 mg topically in patients with left ventricular failure. Left ventricular filling pressure fell 5.3 mmHg 10 min after sublingual nitroglycerin (p < 0.05) in 7 patients, but returned to control by 20 min. In the same patients left ventricular filling pressure fell 3.7 mmHg 60 min after oral nitroglycerin and remained down another 15 min. In 10 other patients left ventricular filling pressure fell 4.6 mmHg (p < 0.05) 40 min after topical nitroglycerin with peak reduction of 6.7 mmHg (p < 0.01) at 60 min and remained lower beyond 4 hr. Blood pressure fell slightly and cardiac index increased 0.51 L/min/M2 after sublingual and topical nitroglycerin. Sublingual nitroglycerin is too short acting, oral nitroglycerin is minimally effective, but topical nitroglycerin has prolonged effects rendering it potentially useful for chronic vasodilator therapy.

Original languageEnglish (US)
Pages (from-to)231-245
Number of pages15
JournalCurrent Therapeutic Research - Clinical and Experimental
Volume22
Issue number2
StatePublished - Jan 1 1977

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