Left Ventricular Volume Changes After Amyl Nitrite and Nitroglycerin in Man as Measured by Ultrasound

Abstract

The therapeutic effect of nitrites in myocardial ischemia is considered to be due in part to a reduction of left ventricular volume but measurement of this parameter in man has been difficult. The technique of echocardiography was used to measure changes in left ventricular enddiastolic volume (LVEDV) and end-systolic volume (LVESV) after administration of amyl nitrite (AN) and nitroglycerin (NG) in 20 normal subjects. Control LVEDV was 131 8 ml (mean ±SEM) and LVESV 30+ 2 ml. After AN, LVEDV fell 18 + 2% (P < 0.001) and LVESV by 57 -+-3% (P<0.001) in 15 sec to 1 min. Heart rate (HR) rose from 68 3 to 108 4 beats/min at 1 min and blood pressure (BP) fell from 119/69 3/2 to 99/47 + 4/3 mm Hg. Following NG,

Effects of heating on haemodynamic action of glyceryl trinitrate.

“…The haemodynamic variations after GTN which we have observed at 22°C are similar to those described by other authors (Burggraf & Parker, 1974;Drobinski et al, 1980;Warrington & Burgess, 1980).…”

Use of M‐mode echocardiography in clinical pharmacology.

“…This has been studied by a number of authors. In normal subjects, Burggraf & Parker (1974) found variation of up to 4 mm at end-systole and up to 3 mm at end-diastole in duplicate determinations in normal subjects. Gibson (1973) noted a root mean square difference of 3.5 mm between duplicate determinations of dimension, made within a few minutes of one another, and almost identical results were reported by Roelandt (1977).…”

“…Nitroglycerin: The effects of nitroglycerin have been studied by a number of workers in both normal subjects and patients with ischaemic heart disease, with or without evidence of incoordinate contraction (Redwood et al, 1974;Burggraf & Parker, 1974;Hardarson & Wright, 1976). The effects of sublingual nitroglycerin are similar in all three, with significant reductions in both end-diastolic and end-systolic dimensions, by up to 5 mm, and an increase in mean VCF and heart rate.…”

Sustained hemodynamic and antianginal effect of high dose oral isosorbide dinitrate.

“…Patients received oral ISDN and oral placebo of identical appearance in a randomized, doubleblind, crossover manner.t In addition to blood pressure and heart rate determinations prior to and during each exercise test, blood pressures and heart rates were measured in a sitting position at 15,30,45,90,120,150,240, and 270 min after oral drug administration.…”