Effects of sublingual nitrate in patients receiving sustained therapy of isosorbide dinitrate for coronary artery disease.
To examine the effects of sublingual isosorbide dinitrate (ISDN) in patients receiving sustained ISDN therapy, 24 patients with coronary artery disease were divided into 2 groups. Group C comprised 12 patients without sustained ISDN therapy and group N included 12 patients with sustained ISDN therapy. Before and during administration of sublingual ISDN in both groups, aortic systolic pressure, left ventricular end-diastolic pressure and coronary artery diameter were examined at cardiac catheterization. During sublingual ISDN, the aortic systolic pressure decreased by 20 +/- 6% (138 +/- 26 to 112 +/- 27 mm Hg, p less than 0.01) in group C and 10 +/- 6% (127 +/- 26 to 113 +/- 23 mm Hg, p less than 0.01) in group N (p less than 0.01, group C vs group N). The left ventricular end-diastolic pressure decreased by 65 +/- 16% (11 +/- 5 to 4 +/- 3 mm Hg, p less than 0.01) in group C and 43 +/- 14% (12 +/- 5 to 7 +/- 3 mm Hg, p less than 0.01) in group N (p less than 0.01, group C vs group N). During sublingual ISDN, the diameters of the proximal and distal segments of the left anterior descending and circumflex coronary arteries increased more significantly in group C than in group N (p less than 0.01, group C vs group N). Thus, sublingual ISDN produced less reduction of aortic systolic pressure and left ventricular end-diastolic pressure, and less dilation of coronary artery diameter in patients receiving sustained therapy with ISDN than in those without sustained therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Cardiology, Saiseikai Yamaguchi General Hospital, Yamaguchi, Japan.
H
H
Naito
Y
Y
Matsuda
K
K
Shiomi
T
T
Yorozu
T
T
Maeda
H
H
Lee
K
K
Seki
H
H
Nakashima
D000286:Administration, Sublingual; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000188:drug therapy*; D003331:Coronary Vessels / Q000187:drug effects; D003692:Delayed-Action Preparations; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D013318:Stroke Volume / Q000187:drug effects; D014664:Vasodilation / Q000187:drug effects
D003692:Delayed-Action Preparations; D007548:Isosorbide Dinitrate