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硝酸甘油及长效有机硝酸盐是最先用于改善充血性心衰(CHF)左室功能的全身血管扩张剂。但临床长期效益受到其作用短暂的限制,因此对24小时经皮硝酸甘油(TDN)制剂甚感兴趣,本研究观察一大组CHF患者对TDN的血液动力学反应,力求解释某些CHF有效而有一些无效的原因。本组22例严重慢性CHF患者,男15,女7,年龄26-77岁。10例缺血性心脏病,11例扩张性心肌病,1例严重二尖瓣回流。研究开始给患者作右心导管及动脉插管,比较患者舌下、口服及经皮给硝酸甘油的血液动力学效益。结果:19/22例对舌下含服硝酸甘油有效,3例无反应,即使剂量增加至0.8毫克及口服消心痛
Nitroglycerin and long-acting organic nitrates are the first systemic vasodilators to improve left ventricular function in patients with congestive heart failure (CHF). However, long-term clinical benefits are limited by their role and are therefore of interest for 24-hour preparations of transdermal nitroglycerin (TDN). This study looked at the hemodynamic response of a large group of CHF patients to TDN in an effort to explain the efficacy of some of the CHFs There are some invalid reasons. The group of 22 patients with severe chronic CHF, male 15, female 7, aged 26-77 years. 10 cases of ischemic heart disease, 11 cases of dilated cardiomyopathy, and 1 case of severe mitral valve regurgitation. The study began with a right heart catheterization and arterial cannulation to compare hemodynamic benefits of sublingual, oral and transdermal nitroglycerin in patients. Results: 19/22 patients were effectively treated with sublingual nitroglycerin, and 3 patients did not respond, even if the dose was increased to 0.8 mg and oral administration of heartburn