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      Differente suscettibilità allo sviluppo di tolleranza alla nitroglicerina nella circolazione venosa ed arteriosa periferica dell·uomo

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          Abstract

          Aim of the study was to assess the relative susceptibility to the development of nitroglycerin tolerance in the arterial and venous circulation in man and to evaluate the interactions between nitroglycerin and N-acetyl-cysteine. Twenty patients with coronary artery disease underwent a continuous 24-h nitroglycerin infusion followed by a bolus administration of N-acetylcysteine. Forearm blood flow (ml/lOOml/min) and venous volume (ml/l00 ml) were measured by strain gauge plethysmography under control conditions, at the end of nitroglycerin titration, after 24 h of infusion and after N-acetylcysteine; vascular resistance was calculated as mean cuff blood pressure/flow. After 24 h of nitroglycerin infusion, the initial increase in venous volume was reduced by 48 % (p < 0.01), while the acute effects on vascular resistance were not attenuated in the whole group. N-acetylcysteine restored nitroglycerin venodilator effects in all 10 patients who developed venous tolerance but did not change significantly vascular resistance in 5 patients in whom attenuation of the arterial effects was observed during the infusion period. In conclusion, the results indicate that the susceptibility to the development of nitrate tolerance in man is higher in the venous than in the arterial circulation and that the sulphy-dryl group donor N-acetylcysteine is more effective in reversing nitroglycerin tolerance in the venous than in the arterial circulation.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5893-8
          978-3-318-01947-6
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 84
          : Suppl 1
          : 64-70
          Affiliations
          Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia, Italia
          Article
          176446 Cardiology 1994;84:64–70
          10.1159/000176446
          8087826
          © 1994 S. Karger AG, Basel

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          Pages: 7
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