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Effects of nitroglycerin on supine and upright exercise in mitral stenosis

, : Effects of nitroglycerin on supine and upright exercise in mitral stenosis. American Heart Journal 104(6): 1288-1293

Resting, supine, and upright exercise hemodynamics were studied in 11 patients with pure or predominant mitral stenosis before and after 0.4 mg sublingual nitroglycerin. Resting mean pulmonary wedge pressure was reduced from 27 +/- 1.6 to 21 +/- 1.6 mm Hg (p less than 0.001), while mean cardiac index (2.98 +/- 0.40 vs 2.68 +/- 0.30 cc/min/m2; NS) and mean heart rate (82 +/- 4.4 vs 87 +/- 6.7 bpm; NS) were unchanged after nitroglycerin. Resting mean left ventricular end-diastolic pressure dropped from 11 +/- 1.7 to 8 +/- 1.1 mm Hg (p less than 0.02) after nitroglycerin, while stroke index (37 +/- 5.1 vs 32 +/- 3.8 mm Hg; NS) was unchanged. Left ventricular systolic pressure fell from 122 +/- 6.0 to 111 +/- 3.1 mm HG (p less than 0.001) after nitroglycerin. At peak supine exercise similar qualitative changes were observed. Mean pulmonary wedge pressure was lower after nitroglycerin (43 +/- 2.3 vs 36 +/- 2.1 mm Hg; p less than 0.02), while cardiac index (3.62 +/- 0.39 vs 3.4 +/- 0.26 cc/min/m2; NS) and heart rate (116 +/- 7.1 vs 113 +/- 4.6 bpm; NS) were not different. Left ventricular end-diastolic pressure (13 +/- 1.4 vs 10 +/- 1.3; NS) was slightly but not significantly reduced by nitroglycerin. Left ventricular stroke index (34 +/- 3.4 vs 31 +/- 2.2 mm Hg; NS) was unchanged by nitroglycerin. Left ventricular systolic pressure (137 +/- 7.3 vs 127 +/- 6.1 mm Hg; p less than 0.02) was reduced 10 mm Hg at peak supine exercise after nitroglycerin. During upright exercise, peak heart rate (160 +/- 8.1 vs 160 +/- 8.0 bpm; NS) and peak systolic blood pressure (117 +/- 5.7 vs 112 +/- 2.8 mm Hg; NS) were not changed with nitroglycerin. Exercise duration was improved after nitroglycerin (5.02 +/- 0.62 vs 5.66 +/- 0.65 minutes; p less than 0.02). Thus sublingual nitroglycerin lowers mean pulmonary wedge pressure to reduce pulmonary congestive symptoms, improves supine exercise hemodynamics, and may enhance treadmill exercise duration in some patients with pure or predominant mitral stenosis.


PMID: 6816056

Other references

Molodov, P.A., 1959: Some anatomo-physiological features of the forearm and its significance in treatment of closed diaphyseal fractures. Ortopediia Travmatologiia i Protezirovanie 20(1): 23-30

Rizzo, S., 2003: Eosinophilic pleuropericarditis and fasciitis. A new case. The case of a 29 year old male, non-smoker, with moderate dyspnea and subcutaneous limb swelling was reported. The final diagnosis of eosinophilic pleuropericarditis and fasciitis based on the presence of pleuropericardial effusion, painful arthro...

Pieragnoli, E., 1956: Histogenic and endocrinologic considerations on Brenner's tumor. Folia Endocrinologica; Mensile di Incretologia E Incretoterapia 9(4): 517-527

Gambaryan, P.P.; Terteryan, A.E., 1973: Numerical taxonomy of Simuliids of the genus Eusimulium Roub. (Diptera, Simuliidae). Fifty-six species and two subspecies of Eusimulium [which is regarded in this Review as a subgenus of Simulium] are distinguished and divided into 8 groups on the basis of 13 quantitative characters.

Chu, Y-H.; Wang, Z-M.; Yamagishi, M.; Kanoh, H.; Hirotsu, T.; Zhang, Y-X., 2005: Synthesis of nanoporous graphite-derived carbon-silica composites by a mechanochemical intercalation approach. A mechanochemical intercalation approach which applies a simple mechanical milling to induce intercalation reaction was applied to introduce controlled amount of tetraethoxylsilane (TEOS) into surfactant-preexpanded graphite oxide, and the relatio...

Wu, Q.; Wang, X.; Qi, G.; Guo, Q.; Pan, S.; Meng, X.; Xu, J.; Deng, F.; Fan, F.; Feng, Z.; Li, C.; Maurer, S.; Müller, U.; Xiao, F-Shou., 2014: Sustainable synthesis of zeolites without addition of both organotemplates and solvents. The development of sustainable and environmentally friendly techniques for synthesizing zeolites has attracted much attention, as the use of organic templates and solvents in the hydrothermal synthesis of zeolites is a major obstacle for realizing...

Kadiri, L.; Poynter, A.; Waldock, P., 1999: An external marker for accurate patient positioning in radiotherapy CT scanning. RadioTherapy and Oncology 48(3): 343-344

Ireland, G.W.; Dopping-Hepenstal, P.; Jordan, P.; O'Neill, C., 1987: Effect of patterned surfaces of adhesive islands on the shape, cytoskeleton, adhesion and behaviour of Swiss mouse 3T3 fibroblasts. A pattern of circular islands of adhesive substratum can be used to control cell shape and behaviour. We have shown previously that the proportion of Swiss 3T3 cells that synthesize DNA varies with the area of the island to which they are attached...

Plakseĭchuk, I.A., 1973: Comparative evaluation of the methods for treating fractures of the capitulum humeri in children. Vestnik Khirurgii Imeni I. I. Grekova 111(10): 84-87

Tulloh, C.G., 1972: The aqueous flow and permeability of the blood-aqueous barrier in retinal detachment. Transactions of the Ophthalmological Societies of the United Kingdom 92: 585-611