Nitroglycerin ointment in acute myocardial infarction

Armstrong, Paul W.; Mathew, Mevin; Boroomand, Kayoomars; Parker, John O.

doi:10.1016/0002-9149(76)90466-5

Cited by 47 publications

(5 citation statements)

References 12 publications

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“…The heart rate either decreased or did not change significantly. Increase in the transmyocardial gradient indicates that coronary perfusion pressure improved with treatment [1]. The de crease in double product reflects a reduction in myocardial oxygen con sumption [3], The decrease in échocardiographie left ventricular end diastolic dimension and the fall in wedge pressure were probably the re sult of venous dilatation, while arteriolodilatation probably caused the increase in cardiac output.…”

Section: Discussionmentioning

confidence: 99%

Use of Nitroglycerin Ointment in Congestive Heart Failure

Chandraratna¹,

Langevin²,

Odell³

et al. 1978

Cardiology

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7 consecutive patients with congestive heart failure refractory to standard therapy were treated with nitroglycerin ointment (GTNO). The pulmonary wedge pressure decreased from a control value of 30 ± 1 to 15 ± 1 mm Hg (mean ± SEM), and the arteriovenous oxygen difference narrowed from 6.8 ± 0.5 to 5.5 ± 0.3 ml%, after GTNO therapy. The heart rate decreased in 5 patients and the systolic blood pressure was either unchanged or decreased slightly. A reduction in the echocardiographic end diastolic dimension was noted in all patients. The transmyocardial gradient (systemic artery diastolic pressure – pulmonary artery wedge pressure) increased in all except 1 subject. The double product decreased in 5 of the 7 patients. Hemodynamic improvement was maintained for 4.5–7 h. All patients were symptomatically improved on chronic GTNO treatment. Our results indicate that GTNO is a useful agent in the management of heart failure which is unresponsive to standard therapy.

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Section: Discussionmentioning

confidence: 99%

Use of Nitroglycerin Ointment in Congestive Heart Failure

Chandraratna¹,

Langevin²,

Odell³

et al. 1978

Cardiology

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“…The decline in pulmonary artery and left ventricular filling pressures with nitroglycerin in heart failure appears to be due to a significant venodilator effect (17,22). This preload reducing effect of nitroglycerin paste persisted for 3 h, as shown by others (2). The selection of nitroglycerin paste rather than other vasodilator, i. e. isosorbide dinitrate, was made since nitroglycerin may have additional beneficial effects on coronary hemodynamics (21).…”

Section: Discussionmentioning

confidence: 90%

Non‐parenteral combined afterload and preload reduction therapy in congestive heart failure

Mehta

Pepine

Conti

et al. 1978

Clinical Cardiology

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Summary:It has been shown that hydralazine is beneficial in chronic heart failure by virtue of its afterload reducing effect. Nitroglycerin paste results in venodilation and fall in left ventricular fIlling pressure (L VFP). Thirteen patients with chronic heart failure were given a combination of oral hydralazine and nitroglycerin paste. With oral hydralazine (75 to 100 mg every 8 h), left ventricular stroke work increased and L VFP slightly fell. Following addition of 2 % nitroglycerin paste, an additional decline in mean pulmonary artery and LVFP was observed without significant changes in heart rate and arterial pressure. There were no untoward side effects from either therapy. Eight patients followed for three to eight months (mean five months) reported subjective improvement in shortness of breath and other symptoms related to ventricular dysfunction. This study shows that in certain patients with chronic heart failure, hydralazine and nitroglycerin paste combination produces salutary clinical effects on long term probably through afterload and preload reduction, respectively.

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“…Following application of 2.5 cm of 2% nitroglycerin ointment to these individuals, mean pulmonary capillary wedge pressure, pulmonary artery pressure, and systemic blood pressure were significantly decreased by 30 minutes and a sustained decline was observed up to five hours. All of these patients had control pulmonary capillary wedge pressures greater than 14 mmHg (mean 26 Taylor et al20 also demonstrated the value of nitroglycerin ointment in their study of ten patients with chronic congestive heart failure. Each patient in this study had a control mean pulmonary capillary wedge pressure of greater than 23 mmHg (range 24 to 45).…”

Section: Introductionmentioning

confidence: 92%

The Transdermal Administration of Nitrates: An Overview

Demma¹,

Wilson²

1983

Angiology

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Nitroglycerin has been the mainstay of the medical management of angina pectoris for over 100 years. The long-held clinical impression of the efficacy of nitroglycerin has now been clearly documented in controlled clinical trials designed to evaluate objective response to antianginal agents. Advances in scientific methodology and improved experimental design have contributed to continuing interest in nitrates. Newer uses of nitroglycerin and other nitrates in congestive heart failure and acute myocardial infarction are the result of a developing understanding of the pharmacology of nitrates.

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Nitroglycerin ointment in acute myocardial infarction

Cited by 47 publications

References 12 publications

Use of Nitroglycerin Ointment in Congestive Heart Failure

Use of Nitroglycerin Ointment in Congestive Heart Failure

Non‐parenteral combined afterload and preload reduction therapy in congestive heart failure

The Transdermal Administration of Nitrates: An Overview

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