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. 1977 Aug;60(2):295–301. doi: 10.1172/JCI108777

Comparison of Nitroglycerin-, Nitroprusside-, and Phentolamine-Induced Changes in Coronary Collateral Function in Dogs

Norine L Capurro 1, Kenneth M Kent 1, Stephen E Epstein 1
PMCID: PMC372369  PMID: 406277

Abstract

The recent use of vasodilators to improve ventricular function in acute myocardial infarction led us to investigate the effects of nitroglycerin, nitroprusside, and phentolamine on coronary collateral flow. Dogs were studied 2-4 wk after an ameroid constrictor was placed around the left anterior descending (LAD) coronary artery. Retrograde flow and peripheral coronary pressure were measured from a cannula inserted in the LAD distal to the ameroid. Systemic arterial pressure was held constant by an aortic cuff. When administered intracoronary (i.c.), nitroglycerin, 0.3-100 μg/min, or nitroprusside, 3-100 μg/min, produced quantitatively similar, dose-dependent increases in retrograde flow. Neither drug, i.c., changed peripheral coronary pressure. Nitroglycerin, 3-300 μg/min, intravenous (i.v.), produced dose-dependent increases in retrograde flow; nitroprusside, i.v., increased retrograde flow only in high doses (100-300 μg/min). Nitroglycerin and nitroprusside, i.v., produced similar increases in peripheral coronary pressure. Phentolamine, 1-300 μg/min, i.v., decreased retrograde flow, and did not change peripheral coronary pressure. Nitroprusside was considerably more potent than nitroglycerin in decreasing systemic arterial pressure and in reducing total coronary resistance. Thus, (a) although i.c. nitroglycerin and nitroprusside produce similar effects on collateral function, i.v. nitroglycerin is more effective than i.v. nitroprusside in augmenting collateral flow; (b) phentolamine has deleterious effects on collateral function; and (c) the relative vasodilator potencies of nitroglycerin and nitroprusside vary in different vascular beds; thus, for a given reduction in systemic arterial pressure, nitroprusside is less effective in increasing retrograde flow.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borer J. S., Kent K. M., Goldstein R. E., Epstein S. E. Nitroglycerin-induced reduction in the incidence of spontaneous ventricular fibrillation during coronary occlusion in dogs. Am J Cardiol. 1974 Apr;33(4):517–520. doi: 10.1016/0002-9149(74)90611-0. [DOI] [PubMed] [Google Scholar]
  2. Borer J. S., Redwood D. R., Levitt B., Cagin N., Bianchi C., Vallin H., Epstein S. E. Reduction in myocardial ischemia with nitroglycerin or nitroglycerin plus phenylephrine administered during acute myocardial infarction. N Engl J Med. 1975 Nov 13;293(20):1008–1012. doi: 10.1056/NEJM197511132932002. [DOI] [PubMed] [Google Scholar]
  3. Capurro N., Kent K. M., Epstein S. E. Effects of intracoronary and intravenous nitroglycerin on coronary collateral function. J Pharmacol Exp Ther. 1976 Oct;199(1):262–268. [PubMed] [Google Scholar]
  4. Chatterjee K., Parmley W. W., Ganz W., Forrester J., Walinsky P., Crexells C., Swan H. J. Hemodynamic and metabolic responses to vasodilator therapy in acute myocardial infarction. Circulation. 1973 Dec;48(6):1183–1193. doi: 10.1161/01.cir.48.6.1183. [DOI] [PubMed] [Google Scholar]
  5. Chiariello M., Gold H. K., Leinbach R. C., Davis M. A., Maroko P. R. Comparison between the effects of nitroprusside and nitroglycerin on ischemic injury during acute myocardial infarction. Circulation. 1976 Nov;54(5):766–773. doi: 10.1161/01.cir.54.5.766. [DOI] [PubMed] [Google Scholar]
  6. Come P. C., Flaherty J. T., Baird M. G., Rouleau J. R., Weisfeldt M. L., Greene H. L., Becker L., Pitt B. Reversal by phenylephrine of the beneficial effects of intravenous nitroglycerin in patients with acute myocardial infarction. N Engl J Med. 1975 Nov 13;293(20):1003–1007. doi: 10.1056/NEJM197511132932001. [DOI] [PubMed] [Google Scholar]
  7. FAM W. M., MCGREGOR M. EFFECT OF CORONARY VASODILATOR DRUGS ON RETROGRADE FLOW IN AREAS OF CHRONIC MYOCARDIAL ISCHEMIA. Circ Res. 1964 Oct;15:355–364. doi: 10.1161/01.res.15.4.355. [DOI] [PubMed] [Google Scholar]
  8. Fam W. M., McGregor M. Effect of nitroglycerin and dipyridamole on regional coronary resistance. Circ Res. 1968 May;22(5):649–659. doi: 10.1161/01.res.22.5.649. [DOI] [PubMed] [Google Scholar]
  9. Flaherty J. T., Reid P. R., Kelly D. T., Taylor D. R., Weisfeldt M. L., Pitt B. Intravenous nitroglycerin in acute myocardial infarction. Circulation. 1975 Jan;51(1):132–139. doi: 10.1161/01.cir.51.1.132. [DOI] [PubMed] [Google Scholar]
  10. Franciosa J. A., Limas C. J., Guiha N. H., Rodriguera E., Cohn J. N. Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet. 1972 Mar 25;1(7752):650–654. doi: 10.1016/s0140-6736(72)90460-6. [DOI] [PubMed] [Google Scholar]
  11. Gold H. K., Leinbach R. C., Sanders C. A. Use of sublingual nitroglycerin in congestive failure following acute myocardial infarction. Circulation. 1972 Nov;46(5):839–845. doi: 10.1161/01.cir.46.5.839. [DOI] [PubMed] [Google Scholar]
  12. Goldstein R. E., Stinson E. B., Scherer J. L., Seningen R. P., Grehl T. M., Epstein S. E. Intraoperative coronary collateral function in patients with coronary occlusive disease. Nitroglycerin responsiveness and angiographic correlations. Circulation. 1974 Feb;49(2):298–308. doi: 10.1161/01.cir.49.2.298. [DOI] [PubMed] [Google Scholar]
  13. Hirshfeld J. W., Jr, Borer J. S., Goldstein R. E., Barrett M. J., Epstein S. E. Reduction in severity and extent of myocardial infarction when nitroglycerin and methoxamine are administered during coronary occlusion. Circulation. 1974 Feb;49(2):291–297. doi: 10.1161/01.cir.49.2.291. [DOI] [PubMed] [Google Scholar]
  14. Horwitz L. D., Gorlin R., Taylor W. J., Kemp H. G. Effects of nitroglycerin on regional myocardial blood flow in coronary artery disease. J Clin Invest. 1971 Aug;50(8):1578–1584. doi: 10.1172/JCI106645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. KATTUS A. A., GREGG D. E. Some determinants of coronary collateral blood flow in the open-chest dog. Circ Res. 1959 Jul;7(4):628–642. doi: 10.1161/01.res.7.4.628. [DOI] [PubMed] [Google Scholar]
  16. Kelly D. T., Delgado C. E., Taylor D. R., Pitt B., Ross R. S. Use of phentolamine in acute myocardial infarction associated with hypertension and left ventricular failure. Circulation. 1973 Apr;47(4):729–735. doi: 10.1161/01.cir.47.4.729. [DOI] [PubMed] [Google Scholar]
  17. Miller R. R., Vismara L. A., Zelis R., Amsterdam E. A., Mason D. T. Clinical use of sodium nitroprusside in chronic ischemic heart disease. Effects on peripheral vascular resistance and venous tone and on ventricular volume, pump and mechanical performance. Circulation. 1975 Feb;51(2):328–336. doi: 10.1161/01.cir.51.2.328. [DOI] [PubMed] [Google Scholar]
  18. Myers R. W., Scherer J. L., Goldstein R. A., Goldstein R. E., Kent K. M., Epstein S. E. Effects of nitroglycerin and nitroglycerin-methoxamine during acute myocardial ischemia in dogs with pre-existing multivessel coronary occlusive disease. Circulation. 1975 Apr;51(4):632–640. doi: 10.1161/01.cir.51.4.632. [DOI] [PubMed] [Google Scholar]
  19. Smith E. R., Redwood D. R., McCarron W. E., Epstein S. E. Coronary artery occlusion in the conscious dog. Effects of alterations in arterial pressure produced by nitroglycerin, hemorrhage, and alpha-adrenergic agonists on the degree of myocardial ischemia. Circulation. 1973 Jan;47(1):51–57. doi: 10.1161/01.cir.47.1.51. [DOI] [PubMed] [Google Scholar]
  20. Williams D. O., Amsterdam E. A., Mason D. T. Hemodynamic effects of nitroglycerin in acute myocardial infarction. Circulation. 1975 Mar;51(3):421–427. doi: 10.1161/01.cir.51.3.421. [DOI] [PubMed] [Google Scholar]
  21. Winbury M. M., Howe B. B., Hefner M. A. Effect of nitrates and other coronary dilators on large and small coronary vessels: an hypothesis for the mechanism of action of nitrates. J Pharmacol Exp Ther. 1969 Jul;168(1):70–95. [PubMed] [Google Scholar]

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