title: Nitroglycerin improves left ventricular relaxation by changing systolic loading sequence in patients with excessive arterial load.
abstract: Nitroglycerin abbreviates left ventricular (LV) relaxation through improved hemodynamics as well as by direct actions on the myocardium. The aim of this study was to examine whether the changing systolic loading sequence during nitroglycerin administration affects LV relaxation in patients with excessive arterial load. By use of a conductance catheter with microtip manometer, the effects of intravenous nitroglycerin (0.3-0.5 microg/kg/min) on LV function and hemodynamics were examined in 39 patients with various degrees of LV contractility. Patients were divided into two groups according to LV-arterial coupling, the ratio of end-systolic elastance (Ees) to effective arterial elastance (Ea). In patients with Ees/Ea ratio > 1, nitroglycerin had no effect on the time to peak force or on the time constant of LV relaxation (tau). On the other hand, in patients with Ees/Ea < 1, which represented excessive arterial load, nitroglycerin significantly shortened the time to peak force, shifted the peak of the loading sequence from late to early systole, and significantly decreased tau without any changes in Ees. Thus, nitroglycerin improved LV relaxation in patients with excessive arterial load partly by changing the systolic loading sequence.
authors.affiliation: The First Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanabe
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Funabiki
authors.forename: Tairou
authors.initials: T
authors.lastname: Kurita
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Kazuki
authors.initials: K
authors.lastname: Nakajima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000368:Aged; D001158:Arteries / Q000187:drug effects / Q000503:physiopathology*; D006328:Cardiac Catheterization; D005260:Female; D006321:Heart / Q000187:drug effects*; D006331:Heart Diseases / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D005996:Nitroglycerin / Q000627:therapeutic use*; D013599:Systole; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin