[Haemodynamic effects of intravenous isosorbide dinitrate in congestive heart failure]

The effects of intravenous infusion of isosorbide dinitrate (ISDN) were evaluated in 22 patients with congestive heart failure. These patients did not receive vasodilator therapy before this study. Seven of these patients (two bolus groups of 5.0 mg and 7.5 mg each) were infused bolusly. The mean PA, PCWP and mean RA decreased for 5 min and, after 60 min, they were back to the original levels. The mean Ao had an accentuated change when the 7.5 mg bolus was injected, but, apart from that, changes were minimal. The CI changed little and upwardly. ISDN was infused continuously in 10 patients (two infusion groups of 5.0 mg/hr and 7.5 mg/hr each) whose mean PA, PCWP and mean RA decreased for 15 min and continued downwardly but mildly for 120 min. The mean Ao did not change much and the CI slightly increased. Five of the 22 patients (bolus+infusion group of 5.0 mg and 5.0 mg/hr) showed rapid response but the parameters only slightly changed. Since this group included severe heart failure patients, the results observed were milder. The response of all 5 groups receiving ISDN infusion were confirmed by the serum ISDN concentration curve. These results indicate that continuous infusions of 7.5 mg/hr ISDN or bolus infusions of 5.0 mg and infusion of 5.0 mg/hr improved haemodynamics in patients with congestive heart failure.