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European Heart Journal 1984 5(9):697-704;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Beneficial effects of intravenous nitroglycerin on haemodynamics and enzymatically estimated infarct size

J. KOREWICKI, T. KRASKA, G. OPOLSKI, A. OSTRZYCKI and Z. PALYNYCZKO

Department of Cardiology, Institute of Internal Medicine, Medical Academy in Warsaw Lindley'a str. 4, 02-005 Warszawa, Poland

Received 14 October 1983; revised 24 April 1984; .

Abstract

The effects of intravenous nitroglycerin (TNG) were evaluated in 39 patients with a first acute mycocardial infarction, subdivided according to Killip into those with left ventricular failure (N = 24) and those without (N = 15). A group of 38 randomly selected patients treated in a conventional, but unstandardized manner, served as a control (C).

TNG caused a statistically significant reduction in pulmonary artery diastolic pressure, regardless of its initial value, by about 30%. Neither cardiac index nor total peripheral resistance was significantly changed.

Infarct size, measured in gEq of isoenzyme MB creatine kinase (CK-MB), was smaller by about 40% in both subgroups of patients treated with TNG, when compared with the controls. A significant difference was found in peak CK-MB blood levels only in the group of patients with left ventricular failure (Killip classes II and III) treated with TNG.

The best results were obtained when TNG was given not later than 4 h after the onset of the symptoms of infarction.

Key Words: intravenous nitroglycerin • pulmonary artery diastolic pressure • mean arterial pressure • cardiac index • total peripheral resistance • infarct size


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