title: The acute hemodynamic effect of IV nitroglycerin and dipyridamole in patients with pulmonary arterial hypertension: comparison with IV epoprostenol.
abstract: Nitroglycerin and dipyridamole are two commonly available and well tolerated vasoactive medications. Their acute hemodynamic effects in patients with pulmonary arterial hypertension are not well defined in the current literature. The authors retrospectively analyzed the acute hemodynamic effects of IV nitroglycerin, dipyridamole, and epoprostenol in 59 patients with pulmonary arterial hypertension as determined by changes from baseline in systemic and pulmonary hemodynamic parameters. Statistical analysis was performed using the independent sample t test. A p value <0.05 was considered significant. Nitroglycerin is predominantly a vasodilator of the pulmonary vasculature with moderate systemic vasodilator effect, while dipyridamole is primarily a positive inotropic agent. Epoprostenol is a potent vasodilator of both pulmonary and systemic vessels and a strong positive inotropic agent. Nitroglycerin and dipyridamole may be useful in the acute management of pulmonary arterial hypertension.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Sulica
authors.forename: Howard V
authors.initials: HV
authors.lastname: Dinh
authors.forename: Kevin
authors.initials: K
authors.lastname: Dunsky
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.forename: Michael
authors.initials: M
authors.lastname: Poon
mesh_terms: D000208:Acute Disease; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004176:Dipyridamole / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D011464:Epoprostenol / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D004176:Dipyridamole; D011464:Epoprostenol; D005996:Nitroglycerin