Efficacy and Rebound Phenomenon Related To Intermittent Nitroglycerin Therapy for the Prevention of Nitrate Tolerance
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概要
- 論文の詳細を見る
Intermittent transdermal therapy of nitroglycerin(NTG)has been recommended for the prevention of nitrate tolerance, but a rebound phenomenon has been reported to occur following removal of the NTG tape. The present study investigated the effects of intermittent NTG therapy on vasodilatory response and the intracellular production of cyclic GMP(cGMP). The study group comprised 12 healthy adults and measurements were taken of the platelet cGMP level, the venous volume(VV)(by forearm plethysmography)and the plasma levels of neurohormonal factors before and 5 min after administration of 0.3 mg of sublingual nitroglycerin(NTG)during the following 4 phases:(i)the control phase(8.00h);(ii)the continuous phase(8.00h;7 days after continuous application of a 10mg/24h NTG tape);(iii)the intermittent application phase(8.00h;7 days after intermittent application of NG tape, applied at 21.00h and removed at 9.00h);and (iv)the intermittent removal phase(13.00h;4h after removal of the NTG tape in the intermittent phase). The percentage increase in cGMP(%cGMP)and venous volume(%VV)were significantly lower in the continuos phase than the control phase, but there was no difference between the control and the intermittent application phases. However, in the intermittent removal phase, the cGMP level before sublingual NTG, the %cGMP and the %VV were unchanged, but the VV before sublingual NTG was significantly lower than in the control phase. Plasma renin activity and the plasma level of angiotensin II were significantly increased in the continuous phase, the intermittent application phase, and the intermittent removal phase. In conclusion, intermittent transdermal NTG therapy prevented nitrate tolerance in the production of cGMP and vasodilation, but induced a rebound phenomenon after removal of the NTG tape. The rebound phenomenon following the tape removal may be related to some other mechanism, such as activation of neurohormonal factors.
- 社団法人日本循環器学会の論文
- 1998-07-20
著者
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OHTSUKA Sadanori
Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Scie
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Sugishita Yasuro
Tsukuba Memorial Hospital
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Sugishita Yasuro
Cardiovascular Division, Departments of Medicine, Institute of Clinical Medicine, University of Tsuk
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Watanabe Hideki
Department Of Cardiology Kinu Medical Association Hospital
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Sugishita Yasuro
Department Of Medicine Tsukuba Memorial Hospital
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Ohtsuka Sadanori
Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc
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Ohtsuka Sadanori
Department Of Internal Medicine Institute Of Clinical Medicien University Of Taukuba
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Ohtsuka Sadanori
Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine University Of
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Sugishita Yasuro
The Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine Universit
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Sugishita Yasuro
2nd Dept. Of Intern. Med. Faculty Of Med. Univ. Of Tokyo
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Sugishita Yasuro
Cardiovascular Division Department Of Internal Medicine And Department Of Gynecology And Obstetrics
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Sugishita Yasuro
Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine The Universit
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Kakihana Masaaki
Ibaraki Prefectural University of Health Sciences, Ami
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Ohtsuka Sadanori
Cardiovascular Medicine Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc
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Ohtsuka Sadanori
Departments Of Cardiology Institute Of Clinical Medicine University Of Tsukuba
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Sugishita Yasuro
Departments Of Cardiology Institute Of Clinical Medicine University Of Tsukuba
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Kakihana Masaaki
Ibaraki Prefectural University Of Health Sciences
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Ohtsuka Sadanori
Department Of Internal Medicine The University Of Tsukuba
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Kazama Masahiro
Institute Of Clinical Medicine University Of Tsukuba
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Sugishita Yasuro
Clinical Medicine
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Sugishita Yasuro
The Department Of Internal Medicine Univeersity Of Tsukuba
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Otsuka Sadanori
Institute Of Clical Medicine University Of Tsukuba
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Sugishita Yasuro
Cardiovascular Division Department Of Internal Medicine University Of Tsukuba
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Sugishita Yasuro
Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine The Universit
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Kakihana Masaaki
Department Of Medicine Institute Of Clinical Medicine University Of Tsukuba
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Watanabe Hideki
Departement Of Cardiology Kinu Medical Association Hospital
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Kakihana Masaaki
2nd Dept. Of Internal Medicine Fac. Of Medicine Univ. Of Tokyo.
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Sugishita Yasuro
Cardiovascular Division Department Of Medicine Institute Of Clinical Medicine The University Of Tsuk
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Sugishita Yasuro
Department Of Internal Medicine University Of Tsukuba
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Sugishita Yasuro
Cardiovascular Division. Department Of Internal Medicine Institute Of Clinical Medicine. The Univers
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