[Haemodynamic and coronary effects of Risordan injection in patients with coronary disease (author's transl)]

Nitro-compounds exert a preventive action on myocardial ischaemia through their peripheral effects (reduction of left ventricular preload) and their effects on the coronary system (increase of collateral flow and imprevement in the endocardium: epicardium perfusion ratio). The haemodynamic, coronary and metabolic effects of Risordan i.v. infusions (5 mg/h) in acute myocardial ischaemia induced by rapid atrial stimulation (RAS) were investigated in 15 male patients with angiographic or ECG signs of non-perfusion of the coronary network. Coronary sinus blood flow was measured by the thermodilution method. The values measured or calculated were: heart rate (HR), cardiac index (CI), aortic pressure (PAo), pulmonary capillary pressure (PCP), right atrial pressure (RAP), systemic arterial resistance (SAR), double product (DP), coronary blood flow (QCcor), total coronary resistance (TCR), O2 arterio venous difference (DAVO2), myocardial O2 consumption (MVO2) and myocardial lactate extraction (K %). RAS produced a significant increase of PAo, CI, DP, MVO2 and QCcor, with inversion of K % (-3.3%) indicatif anaerobic metabolism by myocardial ischaemia. Risordan produced significant diminution of PAo and CI with subsequent increase of HR; there was little increase of DP, MVO2 and QCcor and little change n myocardial metabolism (K % = 14 %). Risordan corrected the myocardial ischaemia induced by RAS, with decrease of PAo, PCP, RAP, CI, DP and QCcor, K % became positive (+ 11.5 % vs -3.3 % during RAS) suggesting a decrease in myocardial ischaemia.