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Effect of slow-release ISDN on cardiac function in patients with coronary heart disease during bicycle ergometry
Insights
Slow-release isosorbide dinitrate (ISDN) effectively reduced cardiac workload in coronary heart disease patients during exercise. ISDN lowered pulmonary and aortic pressures, indicating reduced left ventricular preload and afterload.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary heart disease (CHD) poses significant risks, necessitating effective management strategies.
- Understanding the hemodynamic effects of vasodilators like isosorbide dinitrate (ISDN) is crucial for CHD treatment.
Purpose of the Study:
- To investigate the impact of a single dose of slow-release isosorbide dinitrate (ISDN) on cardiac function in patients with CHD.
- To assess hemodynamic changes at rest and during exercise following ISDN administration.
Main Methods:
- A study involving 10 patients diagnosed with coronary heart disease.
- Hemodynamic parameters were measured using right heart catheterization and thermodilution, including heart rate (HR), cardiac index (CI), pulmonary artery pressures (PASP, PAMP, PAEDP), aortic pressures (AoSP, AoMP, AoEDP), and systemic vascular resistance (SVR).
- Measurements were taken at rest and during bicycle ergometry at baseline (placebo) and 2 and 6 hours after a 40 mg dose of slow-release ISDN.
Main Results:
- At rest, pulmonary artery systolic and mean pressures (PASP, PAMP) were significantly reduced only at 6 hours post-ISDN.
- During exercise, ISDN significantly reduced pulmonary artery pressures (PASP, PAMP) at both 2 and 6 hours.
- Aortic systolic pressure (AoSP) was also significantly reduced at 2 and 6 hours post-ISDN during exercise. No significant changes in HR, CI, or SVR were observed compared to placebo.
Conclusions:
- Slow-release isosorbide dinitrate effectively reduces left ventricular preload and afterload in CHD patients, particularly during exercise.
- The findings suggest ISDN's utility in managing cardiac workload in patients with coronary heart disease under physical stress.
Abstract:
In 10 patients with coronary heart disease (CHD), the effect of a single doses of slow-release isosorbide dinitrate (ISDN) on cardiac function was investigated. Haemo-dynamics was examined by right heart catheterization and thermodilution measurement of cardiac output. After placebo and after 2 and 6 hours with 40 mg ISDN, the heart rate (HR), cardiac index (CI), pressure values in the pulmonary artery (PASP, PAMP, PAEDP) and in the aorta (AoSP, AoMP, AoEDP) and systemic vascular resistance (SVR) were measured at rest and during bicycle ergometry. At rest, PASP and PAMP were significantly reduced only 6 hours after ISDN. Under exercise conditions, significantly reduced pressure values in the pulmonary artery were found 2 and 6 hours after ISDN. AoSP was likewise reduced 2 and 6 hours after ISDN. HR, CI and SVR showed no significant differences compared with placebo values. Thus, an effective reduction of left ventricular preload and afterload was seen in patients with CHD during bicycle ergometry.