Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study compares the effects and duration of the effects of 5 mg. of sublingual (SL) isosorbide dinitrate (ISD), 20 mg. of oral ISD, and 0.4 mg. of SL nitroglycerin (TNG) on central circulatory dynamics. Twenty-seven patients with coronary artery disease were evaluated with radioisotope techniques and determinations made of heart rate (HR), blood pressure (BP), cardiac index (CI), stroke volume index (SVI), left ventricular enddiastolic volume index (LVEDVI), and left ventricular ejection fraction (LVEF). There were significant and equivalent reductions in BP, SVI, LVEDVI, and CI 15 minutes after TNG, 1 hour after SL ISD, and 4 hours after oral ISD in addition to comparative increases in HR and EF by all drugs at these same time intervals. The effects of TNG were gone at 30 minutes while changes in LVEDVI, LVEF, and CI were present 4 hours after SL ISD and persistent changes in LVEDVI and SVI present 6 hours after oral ISD. We conclude that nitrates have significant effects on both preload and afterload and that the duration of effects of sublingual and oral ISD are truly long acting as compared to TNG.
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PMID:Effects of isosorbide dinitrate and nitroglycerin on central circulatory dynamics in coronary artery disease. 82 3

The hemodynamic effects of combined therapy utilizing sodium nitroprusside (SNP) and nitroglycerin (TNG) were compared with those of TNG therapy in patients who underwent coronary artery bypass grafting (CABG). Of 58 patients who received catecholamine infusion to maintain hemodynamics after CABG, 17 had perioperative myocardial infarction (PMI (+) cases) and the other 41 had not PMI (PMI (-) cases). 26 of 41 patients (PMI (-) cases) received nitroglycerin therapy (NTG group) and the other 15 patients received combined therapy (SNP + NTG group). 11 of 17 patients (PMI (+) cases) received NTG therapy and the other 6 patients received combined therapy. The hemodynamic valuables, which were studied, were as follows; cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance index, pulmonary vascular resistance index, and deep core temperature. SNP + TNG group revealed significantly lower systemic vascular resistance index and pulmonary vascular resistance index than TNG group in PMI (-) cases. In PMI (+) cases, SNP + TNG group revealed significantly higher cardiac index, stroke volume index, left ventricular stroke work index, and significantly lower pulmonary vascular resistance index than TNG group. These findings demonstrate that combined therapy can obtain more secure vasodilation than TNG therapy.
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PMID:[Vasodilator therapy utilizing nitroprusside and nitroglycerin after coronary artery surgery]. 250 May 51

The relationships between ventricular function, coronary blood flow, and myocardial oxygen consumption after sublingual administration of 1.6 mg nitroglycerin (TNG) were investigated in 12 patients. Left ventricular volumes, determined from cineventriculograms (enddiastolic volume index and endsystolic volume index), decreased (p less than 0.005) after TNG, as did left ventricular peak pressure (p less than 0.01), left ventricular enddiastolic pressure (p less than 0.005), mean aortic pressure (p less than 0.005), and mean pulmonary artery pressure (p less than 0.001). Due to the decrease in enddiastolic volume and the insignificant change in stroke volume, ejection fraction increased (p less than 0.05). Heart rate did not change significantly. In spite of an increase in the vessel diameter (13%, p less than 0.005), systolic and diastolic coronary blood flow, measured by means of a photodensitometric technique, decreased insignificantly by an average of approx. 15%. Similarly the change in myocardial oxygen consumption, calculated according to Bretschneider, decreased insignificantly by an average of approx. 10%. The correlation of changes in coronary blood flow and myocardial oxygen consumption was evaluated statistically by the use of the 2 X 2 contingency table in conjunction with the chi 2 McNamar test: patients with a decrease in myocardial oxygen consumption also showed a decrease in coronary blood flow (p less than 0.05). This implies that coronary blood flow is determined by myocardial oxygen consumption, which is altered by the systemic effects of TNG.
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PMID:[Relations between ventricle function, myocardial oxygen consumption and coronary circulation following sublingual administration of nitroglycerin]. 641 93

Central haemodynamics and ventilation-perfusion (VA/Q) distribution were studied in nine patients, 21 h after coronary bypass surgery, before and during nitroglycerin (TNG) infusion. VA/Q distributions were established with the multiple inert gas elimination technique of Wagner and West. Administration of TNG resulted in a decrease in mean arterial pressure, a slight reduction in cardiac output and stroke volume and a significant increase in heart rate, possibly explained by an initial relative hypovolaemia. Pulmonary arterial pressures and filling pressures for the right and left ventricles decreased significantly. There was a significant reduction in PaO2 and an increase in venous admixture (QVA/QT) from 11.3 to 16.5% of cardiac output. This was mainly due to an initial SF6-shunt of 6.4% increasing to 12.8%. Only 3.5% of cardiac output during TNG was due to perfusion of hypoventilated areas. The mean for the control Q-distribution was 0.88 with a mean log s.d. of +/- 1.14, indicating VA/Q-mismatch and did not change significantly. The reduction of pressures in the pulmonary vascular bed was accompanied by increased ventilation of areas with high VA/Q.
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PMID:Effects of nitroglycerin on central haemodynamics and VA/Q distribution early after coronary bypass surgery. 681 75

Effects of vasodilation by prostaglandin E1 (PGE1), nicardipine (NIC) and nitroglycerin (TNG) were investigated separately in adult mongrel dogs. Mean arterial pressure was lowered and maintained at 90% and 70% of the control value. Cardiac output (CO), pulmonary arterial pressure (PAP), pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) were measured by a thermodilution pulmonary artery catheter and blood flow of hepatic artery (HABF), portal vein (PVBF) and mesenteric artery was measured by electromagnetic flowmetry. 1) PGE1: Heart rate (HR) and CO were unchanged and left ventricular stroke work (LVSW) decreased. HABF was unchanged, but PVBF increased significantly. 2) NIC: HR increased and systemic vascular resistance decreased significantly. Therefore, CO increased remarkably, compared with the other two drugs. Though LVSW was unchanged, right ventricular stroke work (RVSW) increased with elevation of PAP. In the hepatic circulation, HABF and PVBF decreased slightly. 3) TNG: LVSW and RVSW decreased significantly. HABF increased slightly and PVBF increased significantly.
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PMID:[Haemodynamic effects of vasodilators in dogs--a comparison of prostaglandin E1, nicardipine and nitroglycerin]. 843 48