[Hemodynamic effects of isosorbide-5-mononitrate in coronary heart disease. A comparison of acute and chronic treatment].
The haemodynamic effect of isosorbide-5-mononitrate (ISMN) was studied in 20 patients with coronary heart disease. Three hours after the first and single dose of 50 mg ISMN, both at rest and on exercise there was a significant decrease in pulmonary artery mean pressure of 30%, while heart rate and systemic blood was an anti-anginal effect, as objectified by the angina threshold and return to normal of previously depressed S-T segments during exercise. After administration of 50 mg ISMN, three times daily for seven days, a single dose of 50 mg ISMN on the eighth day produced a fall in pulmonary artery mean pressure three hours after administration, of only 25% at rest and 20% on exercise, while the anti-anginal effect remained unchanged. Six hours after administration there were no significant changes in haemodynamic variables compared with the initial values. The reduced fall in pulmonary artery mean pressure during chronic administration is interpreted as the development of tolerance with decreased venous pooling, while the unchanged anti-anginal effect is explained by the site of action of the nitrate on the coronary arteries and on the collateral circulation with positive blood redistribution.
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology; D004341:Drug Evaluation; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D013997:Time Factors
C030398:isosorbide-2-mononitrate; D007548:Isosorbide Dinitrate
Hämodynamische Effekte von Isosorbid-5-mononitrat bei koronarer Herzkrankheit. Vergleich von akuter und chronischer Therapie.