[Deterioration of myocardial contractility induced by nitroglycerin infusion in a case of ischemic cardiomyopathy].
To evaluate left ventricular (LV) contractility in a 42-year-old woman with ischemic cardiomyopathy, the brachial arterial pressure and LV end-systolic dimension were simultaneously measured using arterial cannulation and LV echocardiography. Blood pressure progressively decreased with the intravenous infusion of nitroglycerin. When the infusion rate reached 4 micrograms/kg/min, the LV end-systolic dimension increased from 63 mm (control) to 66 mm in association with a decrease in blood pressure (from 137 to 120 mmHg) and heart rate (from 103 to 100 bpm). With the infusion of dobutamine (1.5 micrograms/kg/min), the blood pressure increased to 126 mmHg and the LV end-systolic dimension decreased to 57 mm. These findings suggest that nitroglycerin reduced LV myocardial contractility in this patient. Thus, during the intravenous administration of nitroglycerin (especially in patients with ischemic heart disease), the infusion rate should be carefully determined.
Takeda
K
K
Department of Medicine, Dokkyo University School of Medicine, Tochigi.
Okamura
A
A
Tamano
K
K
Kobayashi
N
N
Kadota
R
R
Nakamura
Y
Y
Nagashima
K
K
Nishiyama
Y
Y
Yamamoto
H
H
Yagi
S
S
D000328:Adult; D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology; D003864:Depression, Chemical; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D009200:Myocardial Contraction / Q000187:drug effects*; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects*
D005996:Nitroglycerin