Blog
About

0
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Controlled Study of the Haemodynamic Effects of Isosorbide 5-Mononitrate in Acute Myocardial Infarction

      , , , ,

      Cardiology

      S. Karger AG

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Inview of the favourable results of the short-term therapy of acute myocardial infarction (AMI) with glyceryl-trinitrate (GTN) infusion, we undertook a randomized study to test the hypothesis whether the administration of a single dose of isosorbide 5-mononitrate (IS 5-MN) given orally would have the same favourable haemodynamic effect as observed with GTN infusion. For this purpose we evaluated the haemodynamic effects of IS 5-MN compared to isosorbide dinitrate (ISDN), observed in the same group of patients. 10 patients (8 males, 2 females) aged 50-76 years (mean 63) with AMI (7 anterior, 3 inferior) admitted to the coronary care unit within 48 h from onset of symptoms were entered into this single-blind randomized study; at the time of study entry, 8 patients were in Killip class I, and 2 patients in Killip class II. All drugs with haemodynamic effects were withdrawn 12 h before the study started. Both the haemodynamic profile and the clinical status were stable in all patients. Haemodynamic parameters were recorded with a Swan-Ganz thermodilution catheter, cardiac output was measured by the thermodilution method, and the left ventricular ejection time was calculated according to the Weissler method. The echo left ventricular end-diastolic diameter was measured by evaluation of the M-mode echocardiographic recording. The haemodynamic parameters were measured or calculated in basal condition (-30 min, -10 min, control, as well as +30 min and 1, 2, 3, 4, and 5 h after the administration of the drug (IS 5-MN or ISDN 20 mg orally). IS 5-MN treatment results in no significant change of heart rate but in significant decrease of blood pressure (systolic/diastolic), LVED pressure, right atrial pressure and cardiac index. Furthermore, IS 5-MN induced a significant fall of ventricular stroke work index, tension time index and pressure rate product, considered determinant for myocardial oxygen consumption. In the majority of cases the drug exerts its maximum effect within 1 h, lasting for at least 4-5 h. After administration of ISDN, the same patients showed similar but less stable haemodynamic changes (n.s.). In conclusion, it can be expected that 20 mg of IS 5-MN, given orally to patients with AMI, improve haemodynamics for at least 4–5 h.

          Related collections

          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-4626-3
          978-3-318-01758-8
          0008-6312
          1421-9751
          1987
          1987
          11 November 2008
          : 74
          : Suppl 1
          : 60-64
          Affiliations
          Cardiology Department, Ospedale Maggiore di Milano, Italy
          Article
          174272 Cardiology 1987;74:60–64
          10.1159/000174272
          3111690
          © 1987 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Paper

          General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

          Comments

          Comment on this article