CONTROL OF AFTERLOAD BY INTRAVENOUS NITROGLYCERIN IN PATIENTS UNDERGOING MYOCARDIAL REVASCULARIZATION

  • 1 January 1979
    • journal article
    • research article
    • Vol. 28  (10) , 484-488
Abstract
In 18 patients undergoing aortocoronary bypass grafting, hemodynamic measurements were made before and after hypertensive episodes and i.v. administration of nitroglycerin (NTG). Patients of group 1 (no. = 10) had good left heart function before operation. The mean arterial pressure (MAP) rose during the hypertensive episode from 82 .+-. 12 to 119 .+-. 8 mm Hg (P < 0.001) and the pulmonary capillary wedge pressure (PCWP) increased from 11 .+-. 3 to 15 .+-. 2 mm Hg (P < 0.05). The cardiac index (CI) was not significantly altered. Infusion of NTG decreased the MAP to 84 .+-. 3 mm Hg (P < 0.001), the PCWP to 9 .+-. 3 mm Hg (P < 0.01). The CI remained unchanged. Patients of group 2 (no. = 8) had poor left heart function before operation. During the hypertensive episode the MAP increased from 77 .+-. 15 to 115 .+-. 6 mm Hg (P < 0.001), the PCWP from 13 .+-. 4 to 25 .+-. 5 mm Hg (P < 0.001). The CI decreased from 2.2 .+-. 0.3 to 1.5 .+-. 0.4 l/min .times. m2. Infusion of NTG decreased the MAP to 83 .+-. 4 mm Hg (P < 0.001), the PCWP to 11 .+-. 3 mm Hg (P < 0.001). The CI rose to 2.3 .+-. 0.3 l/min .times. m2 (P < 0.01). Apparently NTG is an effective antihypertensive agent. No untoward side effects were noted.