PMID: 2511685Jan 1, 1989Paper

Improved left ventricular function and topography by prolonged nitroglycerin therapy after acute myocardial infarction

Zeitschrift für Kardiologie
B I JugduttW J Tymchak

Abstract

To determine whether decreasing preload and afterload by prolonged nitroglycerin therapy (NTG) after acute myocardial infarction (AMI) might improve left ventricular (LV) geometry and function, 43 patients with a first anterior transmural AMI (ATAMI) were given low-dose intravenous NTG infusion for the first 48 h and then randomized to buccal NTG (1-3 mg t.i.d., five hourly with an eight-h washout period to avoid vascular tolerance; dose titrated as for i.v. NTG for 10% decrease in blood pressure but not below 80 mm Hg) or placebo for six weeks. All patients had serial two-dimensional echocardiography for 12 weeks for regional LV function and topography: Expansion index = asynergic/non-asynergic endocardial segment length; Thinning ratio = asynergic/normal wall thickness. Asynergy was defined as akinesis + dyskinesis. Between initial and 12-week studies, expansion index did not change in the buccal NTG group (2.09 vs 2.28, N.S.; n = 23) but increased in the placebo group (2.10 vs 2.89, p less than 0.05; n = 20). Over the same period, thinning ratio was unchanged with buccal NTG (0.82 vs 0.77, N.S.) but increased with placebo (0.78 vs 0.66 p less than 0.05). Both expansion and thinning at 12 weeks were greater with placebo than ...Continue Reading

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