Copyright © 1990 by the European Society of Cardiology.
© 1990 The European Society of Cardiology
Nitroglycerin has more favourable effects on left ventricular afterload than apparent from measurement of pressure in a peripheral artery
Cardiology Department, St Vincent's Hospital, Department of Medicine, University of New South Wales
Received 20 April 1989; revised 26 May 1989; .
Address for correspondence: Michael F. O'Rourke, Associate Professor of
Abstract
Nitroglycerin (0-3 mg) was administeredsublingually to 14patients undergoing cardiac catheterization, and pressure waves compared in the ascending aorta and brachial artery. After nitroglycerin, ascending aortic systolic pressure fell in all cases (by 6–44, average 22 mmHg) whereas brachial systolic pressure remained unchanged (in three) or fell to a lesser degree (4–33, average12 mmHg). Diastolic pressure did not change significantly. Alterations in pressure and in wave contour were explained on the basis of arterial dilation, with reduction in wave reflection. Nitroglycerin reduces left ventricular afterload through arterial dilation as well as preload through venous dilation. This effect on afterload is not apparent from measurement of pressure in the brachial artery.
Key Words: Nitroglycerin • afterload • wave reflection
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