Nitrate tolerance in heart failure: differential venous, pulmonary and systemic arterial effects
| Autor: | Arie Shefer, Adam Schneeweiss, David A. Halon, Nabeel Makhoul, Moshe Y. Flugelman, Amnon Merdler, Nader Dakak, Basil S. Lewis |
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| Rok vydání: | 1990 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Cardiac index Hemodynamics Nitroglycerin Drug tolerance Internal medicine medicine Humans Pulmonary wedge pressure Infusions Intravenous Aged Heart Failure business.industry Central venous pressure Drug Tolerance Middle Aged medicine.disease Blood pressure medicine.anatomical_structure Anesthesia Heart failure Cardiology Vascular resistance Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American journal of cardiology. 65(21) |
| ISSN: | 0002-9149 |
| Popis: | The hemodynamic profile of tolerance to intravenous nitroglycerin was studied in 9 patients with New York Heart Association Class III to IV congestive heart failure. After rapid dosage build-up to the maximal tolerated dose (decrease in pulmonary wedge pressure to 10 mm Hg or systolic blood pressure to 90 mm Hg), nitroglycerin (525 +/- 548 micrograms/min) was administered at a constant continuous intravenous infusion for a total of 24 hours. The extent of nitrate tolerance at 24 hours was calculated as the percentage loss of the benefit achieved at time of peak effect of nitroglycerin. Tolerance had a different time course and magnitude in the venous, arterial and pulmonary circulations. At 24 hours, right atrial pressure and pulmonary vascular resistance returned to control values in most patients, while 40 to 50% of the effect on systemic vascular resistance, cardiac index and pulmonary wedge pressure was maintained. These findings emphasize the importance of precise definitions in studies relating to nitrate tolerance. |
| Databáze: | OpenAIRE |
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