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Intravenous isosorbide dinitrate in acute left ventricular failure--a dose--response study.
European Heart Journal
|October 1, 1983
Summary
Intravenous isosorbide dinitrate effectively reduces pulmonary arterial diastolic pressure in severe acute left ventricular failure. Optimal hemodynamic effects are achieved around 200 micrograms min-1 with no observed side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Severe acute left ventricular failure presents significant hemodynamic challenges.
- Intravenous vasodilators are crucial in managing acute heart failure.
Purpose of the Study:
- To assess the hemodynamic effects of intravenous isosorbide dinitrate in severe acute left ventricular failure.
- To determine optimal infusion rates for isosorbide dinitrate therapy.
Main Methods:
- Patients with severe acute left ventricular failure received intravenous isosorbide dinitrate infusions.
- Infusion rates were incrementally increased from 50 to 800 micrograms min-1.
- Hemodynamic parameters including pulmonary arterial diastolic pressure and cardiac index were monitored.
Main Results:
- Pulmonary arterial diastolic pressure significantly decreased from 29 to 23 mmHg at 200 micrograms min-1 (P < 0.001).
- Cardiac index and heart rate remained stable throughout the study.
- No adverse side effects were observed even at higher infusion rates.
Conclusions:
- Intravenous isosorbide dinitrate is an effective and safe treatment for acute severe left ventricular failure.
- An infusion rate of approximately 200 micrograms min-1 provides optimal hemodynamic benefits.
- This dosage allows for significant reduction in pulmonary arterial diastolic pressure without compromising cardiac output or heart rate.
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