Improved Left Ventricular Geometry and Function by Prolonged Nitroglycerin Therapy After Acute Myocardial Infarction

Jugdutt, Bodh I.; Michorowski, B. L.; Tymchak, Wayne

doi:10.1007/978-3-642-58231-8_28

Cited by 3 publications

(4 citation statements)

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“…7,8,23,24 Moreover, it has been shown that nitrates exert a protective effect on the myocardium following stunning and reperfusion damage. 25 The anti-ischemic properties of nitrates have also been demonstrated in our study, since a significant reduction was noted in the maximal ST-segment depression in response to the stress test in the nitrate group compared with the controls.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] Consequently, nitrates are widely used for the treatment of MI in forms ranging from sublingual to transdermal and intravenous. [6][7][8] Two large multicenter studies, Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI-3) and the Fourth International Study of Infarct Survival (ISIS-4), dealt with the effects of nitrates on mortality following MI. 9,10 These two megatrials, in fact, demonstrated no significant decrease in mortality in the nitrate-treated group; merely a small decrease was noted in 6-week mortality, which did not reach a level of significance (for 1,000 patients, this decrease was 2.1 in ISIS-4, and 3.9 in GISSI-3).…”

Section: Introductionmentioning

confidence: 99%

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Effects of long‐term transdermal nitrate treatment on left ventricular function in patients following myocardial infarction

Király

Kiss

Timár

et al. 2003

Clinical Cardiology

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SummaryBackground: Nitrates are widely used for the treatment of myocardial infarction (MI). The large megatrials (GISSI-3 and ISIS-4) did not in fact demonstrate a significant decrease in mortality in the nitrate-treated group. However, examination of the number of postinfarction angina episodes and the occurrence of cardiogenic shock in the GISSI-3 study did reveal significant decreases.Hypothesis: It was hypothesized that chronic nitrate treatment after an MI preserves left ventricular systolic and/or diastolic functions.Methods: Patients were divided into two groups: those receiving chronic nitrate treatment for 6 months after an MI (n = 30), and those without such treatment (n = 29). Echocardiography was performed 3, 14, 42, and 180 days after the infarction. The changes in early diastolic and atrial contractionrelated mitral valve inflow pattern and deceleration time were assayed. Alterations in systolic, diastolic, and atrial reverse flow velocities in the pulmonary vein were measured, as were ejection fraction (EF), the number of registered angina episodes, and the maximal ST-segment depression in response to the stress test.Results: During the 6-month study period, the increase in systolic pulmonary venous flow velocity was significantly larger in the nitrate group than in the controls. The decreases in the velocities of the diastolic and the atrial reverse flow were also more pronounced in the nitrate group than in the controls.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of long‐term transdermal nitrate treatment on left ventricular function in patients following myocardial infarction

Király

Kiss

Timár

et al. 2003

Clinical Cardiology

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“…Lahiri et al [29] found buccal nitroglycerin effective in the chronic treatment of patients with heart fail ure. Jugdutt et al [30] showed that patients after myocardial infarct who were treated for 48 h with nitroglycerin in the course of the acute infarct and subsequently received buc cal nitroglycerin had a better outcome with regard to left ventricle geometry, i.e. infarct expansion and thinning of the wall.…”

Section: Buccal Nitrate Therapymentioning

confidence: 99%

Nitrate Therapy in Heart Failure

Schneider¹,

Bussmann²,

Hartmann³

et al. 1991

Cardiology

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Nitrates are drugs of first choice in patients with acute heart failure. Acute pulmonary edema can be successfully treated with single or repeated doses of sublingual nitroglycerin. In cases of prolonged acute heart failure, e.g. in the setting of acute myocardial infarction, nitroglycerin or isosorbide dinitrate can be given by the intravenous route for up to 24 h. Patients with acute myocardial infarction usually benefit from nitrate therapy if filling pressures are high and/or left ventricular function is compromised. Nitrate therapy can be considered safe if arterial blood pressure is maintained above 95 mm Hg. With these precautions nitrates can reduce infarct size and the incidence of complications as well as improve long-term prognosis. In the chronic treatment concern has risen with regard to possible nitrate tolerance. Thus, therapy schedules allowing for nitrate-poor phases are generally recommended. Therapy schedules with constant-rate delivery of drugs achieved with patches or intravenous administration of nitrates should be used with caution.

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“…Jugdutt and colleagues were able to show that prolonged nitroglycerin therapy decreased infarct expansion and infarct thinning and demonstrated improved hemodynamics, decreased LV volume and asynergy, and increased ejection fraction compared with the effect of placebo. 8 Similarly, angiotensin-converting enzyme inhibitors can alter the hemodynamics of the left ventricle and slow down or prevent ventricular enlargement. Conversely, drugs that increase afterload or slow healing will have the opposite effect.…”

mentioning

confidence: 99%

Ventricular remodeling and prognosis after myocardial infarction

Cr¹

1992

Clin Cardiol

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Improved Left Ventricular Geometry and Function by Prolonged Nitroglycerin Therapy After Acute Myocardial Infarction

Cited by 3 publications

References 4 publications

Effects of long‐term transdermal nitrate treatment on left ventricular function in patients following myocardial infarction

Effects of long‐term transdermal nitrate treatment on left ventricular function in patients following myocardial infarction

Nitrate Therapy in Heart Failure

Ventricular remodeling and prognosis after myocardial infarction

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