Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1970 Nov;32(6):790–794. doi: 10.1136/hrt.32.6.790

Effects of nitroglycerin on left ventricular volumes and wall tension in patients with ischaemic heart disease.

S J Lee, Y K Sung, A J Zaragoza
PMCID: PMC487416  PMID: 5006415

Abstract

Since the dimensions of the ventricles are related to both myocardial tension and myocardial oxygen consumption (MVO2), the effects of nitroglycerin on the left ventricular volumes and left ventricular haemodynamics were studied in patients with ischaemic heart disease. The ventricular volumes were estimated using the constant infusion technique (indocyanine green) of Shaffer (1964). Sublingual administration of nitroglycerin (0.6 mg.) resulted in a significant reduction in cardiac output (27%), mean systolic pressure (21%), left ventricular end-diastolic pressure (63%), stroke volume (27%), left ventricular end-diastolic volume (26%), and left ventricular work (41%). Both calculated circumferential myocardial force (40%) and the myocardial tension (33%) decreased during systole, while the pressure-time index decreased by 27%. A similar decrease was also found in the contractile element work (42%), and mean circumferential fibre shortening rate (22%). Thus, this study has shown that the major determinants of MVO2, i.e. myocardial wall tension, the velocity of contraction, and contractile element work, decrease significantly after administration of nitroglycerin.

Full text

PDF

Selected References

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

  1. BADEER H. S. CONTRACTILE TENSION IN THE MYOCARDIUM. Am Heart J. 1963 Sep;66:432–434. doi: 10.1016/0002-8703(63)90278-3. [DOI] [PubMed] [Google Scholar]
  2. BRACHFELD N., BOZER J., GORIN R. Action of nitroglycerin on the coronary circulation in normal and in mild cardiac subjects. Circulation. 1959 May;19(5):697–704. doi: 10.1161/01.cir.19.5.697. [DOI] [PubMed] [Google Scholar]
  3. BRITMAN N. A., LEVINE H. J. CONTRACTILE ELEMENT WORK: A MAJOR DETERMINANT OF MYOCARDIAL OXYGEN CONSUMPTION. J Clin Invest. 1964 Jul;43:1397–1408. doi: 10.1172/JCI105015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BURCH G. E., RAY C. T., CRONVICH J. A. Certain mechanical peculiarities of the human cardiac pump in normal and diseased states. Circulation. 1952 Apr;5(4):504–513. doi: 10.1161/01.cir.5.4.504. [DOI] [PubMed] [Google Scholar]
  5. Bernstein L., Friesinger G. C., Lichtlen P. R., Ross R. S. The effect of nitroglycerin on the systemic and coronary circulation in man and dogs: myocardial blood flow measured with xenon. Circulation. 1966 Jan;33(1):107–116. doi: 10.1161/01.cir.33.1.107. [DOI] [PubMed] [Google Scholar]
  6. Cowan C., Duran P. V., Corsini G., Goldschlager N., Bing R. J. The effects of nitroglycerin on myocardial blood flow in man, measured by coincidence counting and bolus injections of 84-rubidium. Am J Cardiol. 1969 Aug;24(2):154–160. doi: 10.1016/0002-9149(69)90397-x. [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. GORLIN R., BRACHFELD N., MACLEOD C., BOPP P. Effect of nitroglycerin on the coronary circulation in patients with coronary artery disease or increased left ventricular work. Circulation. 1959 May;19(5):705–718. doi: 10.1161/01.cir.19.5.705. [DOI] [PubMed] [Google Scholar]
  9. Hoeschen R. J., Bousvaros G. A., Klassen G. A., Fam W. M., McGregor M. Haemodynamic effects of angina pectoris, and of nitroglycerin in normal and anginal subjects. Br Heart J. 1966 Mar;28(2):221–230. doi: 10.1136/hrt.28.2.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Klein M. D., Herman M. V., Gorlin R. A hemodynamic study of left ventricular aneurysm. Circulation. 1967 Apr;35(4):614–630. doi: 10.1161/01.cir.35.4.614. [DOI] [PubMed] [Google Scholar]
  11. Knoebel S. B., McHenry P. L., Roberts D., Stein L. Myocardial blood flow in man measured by a coincidence counting system and a single bolus of 84rubidium chloride. Effect of nitroglycerin. Circulation. 1968 Jun;37(6):932–938. doi: 10.1161/01.cir.37.6.932. [DOI] [PubMed] [Google Scholar]
  12. LEVINE H. J., WAGMAN R. J. Energetics of the human heart. Am J Cardiol. 1962 Mar;9:372–383. doi: 10.1016/0002-9149(62)90155-8. [DOI] [PubMed] [Google Scholar]
  13. MONROE R. G., FRENCH G. N. Left ventricular pressure-volume relationships and myocardial oxygen consumption in the isolated heart. Circ Res. 1961 Mar;9:362–374. doi: 10.1161/01.res.9.2.362. [DOI] [PubMed] [Google Scholar]
  14. Parker J. O., West R. O., Di Giorgi S. The hemodynamic response to exercise in patients with healed myocardial infarction without angina: with observations on the effects of nitroglycerin. Circulation. 1967 Nov;36(5):734–751. doi: 10.1161/01.cir.36.5.734. [DOI] [PubMed] [Google Scholar]
  15. Petrle M., Avasthey P. Some problems in the estimation of the end-diastolic volume of the ventricle by dye dilution techniques. Cardiovasc Res. 1968 Apr;2(2):193–198. doi: 10.1093/cvr/2.2.193. [DOI] [PubMed] [Google Scholar]
  16. Rolett E. L., Yurchak P. M., Hood W. B., Jr, Gorlin R. Pressure-volume correlates of left ventricular oxygen consumption in the hypervolemic dog. Circ Res. 1965 Dec;17(6):499–518. doi: 10.1161/01.res.17.6.499. [DOI] [PubMed] [Google Scholar]
  17. SARNOFF S. J., BRAUNWALD E., WELCH G. H., Jr, CASE R. B., STAINSBY W. N., MACRUZ R. Hemodynamic determinants of oxygen consumption of the heart with special reference to the tension-time index. Am J Physiol. 1958 Jan;192(1):148–156. doi: 10.1152/ajplegacy.1957.192.1.148. [DOI] [PubMed] [Google Scholar]
  18. SONNENBLICK E. H. Force-velocity relations in mammalian heart muscle. Am J Physiol. 1962 May;202:931–939. doi: 10.1152/ajplegacy.1962.202.5.931. [DOI] [PubMed] [Google Scholar]
  19. Sonnenblick E. H., Ross J., Jr, Braunwald E. Oxygen consumption of the heart. Newer concepts of its multifactoral determination. Am J Cardiol. 1968 Sep;22(3):328–336. doi: 10.1016/0002-9149(68)90117-3. [DOI] [PubMed] [Google Scholar]
  20. WINBURY M. M. EXPERIMENTAL APPROACHES TO THE DEVELOPMENT OF ANTIANGINAL DRUGS. Adv Pharmacol. 1964;3:1–82. doi: 10.1016/s1054-3589(08)61110-2. [DOI] [PubMed] [Google Scholar]
  21. Williams J. F., Jr, Glick G., Braunwald E. Studies on cardiac dimensions in intact unanesthetized man. V. Effects of nitroglycerin. Circulation. 1965 Nov;32(5):767–771. doi: 10.1161/01.cir.32.5.767. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES