Hemodynamic Effects of Concomitant Nitroglycerin Ointment and Nifedipine Treatment in Acute Myocardial Infarction

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Nitroglycerin ointment and nifedipine were used concurrently for vasodilator therapy in 10 patients with acute myocardial infarction. Nitroglycerin ointment 20mg (4cm) induced a significant reduction in pulmonary capillary wedge pressure from 14.1±1.8 (mean±standard error of the mean) to 12.4±1.2mmHg (p<0.05) 30min after application, while cardiac output, mean blood pressure, and systemic vascular resistance did not show a significant change. When nifedipine 10mg was added orally, mean blood pressure significantly decreased from 99.0±6.3 to 82.8±5.9mmHg (p<0.005) and systemic vascular resistance from 25.7±1.5 to 19.2±1.6 units (p<0.001) 30min after; on the other hand, cardiac index significantly increased from 2.28±0.12 to 2.57±0.141/min/m2 (p<0.001). From these results, it was concluded that combined use of these two drugs was a useful and safe form of unloading therapy.
International Heart Journal刊行会の論文