Dose-response curve of angiographically smooth human epicardial vessel segments to intracoronary injections of isosorbide dinitrate.

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  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7902492 Publication Model: Print Cited Medium: Print ISSN: 0160-2446 (Print) Linking ISSN: 01602446 NLM ISO Abbreviation: J Cardiovasc Pharmacol Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: New York, Raven Press.
    • Subject Terms:
      Heart/*drug effects ; Hemodynamics/*drug effects ; Isosorbide Dinitrate/*pharmacology ; Muscle, Smooth, Vascular/*drug effects ; Vasodilation/*drug effects; Adult ; Cardiac Catheterization ; Coronary Angiography ; Dose-Response Relationship, Drug ; Female ; Humans ; Injections, Intra-Arterial ; Isosorbide Dinitrate/administration & dosage ; Male ; Methylergonovine/pharmacology ; Middle Aged
    • Abstract:
      The coronary vasodilator properties of isosorbide dinitrate are well established but the doses generally used (1,000-2,000 micrograms) are still empirical. We studied, with the use of quantitative coronary arteriography (CAESAR System), the response of smooth vessel segments (greater than 1.85 mm diameter), preconstricted with methylergometrine (400 micrograms i.v.), to intracoronary injections of graded doses (5-100 micrograms) of isosorbide dinitrate and the effects of these injections on systemic hemodynamic parameters in 10 patients undergoing diagnostic coronary angiography. Six further patients, in whom the injections of isosorbide dinitrate were replaced by equivalent volumes of normal saline, served as controls. Relative to the diameter 5 min after injection of methylergometrine, the diameter increased by a mean +/- SD of 9 +/- 7, 26 +/- 12, 33 +/- 15, 38 +/- 14, and 39 +/- 16% after injections of 5, 15, 60, 240, and 1,000 micrograms, respectively, of isosorbide dinitrate. After a cumulative dose of 80 micrograms, subsequent doses did not cause further significant increases in diameter. Injection of saline in the control group did not alter the coronary diameter. A significant fall in systolic arterial pressure, compared to the control group, occurred at a cumulative dose of 320 micrograms. The mean arterial pressure and heart rate were unchanged. Significant coronary vasodilation occurs with intracoronary doses of isosorbide much smaller than those currently employed. Cumulative doses of 320 micrograms or more cause systemic hemodynamic changes without producing additional coronary vasodilation. During interventional cardiac procedures, where systemic hypotension is undesirable, the use of smaller doses of intracoronary isosorbide dinitrate than currently employed may be feasible and should be investigated further.
    • Accession Number:
      IA7306519N (Isosorbide Dinitrate)
      W53L6FE61V (Methylergonovine)
    • Publication Date:
      Date Created: 19920901 Date Completed: 19921209 Latest Revision: 20190724
    • Publication Date:
      20221208
    • Accession Number:
      10.1097/00005344-199209000-00020
    • Accession Number:
      1279295