Bertel O, Baitsch G, Elsässer S, Ritz R, Burkart F
Schweiz Med Wochenschr. 1978 Nov 4;108(44):1735-7.
Ten patients with severe congestive heart failure after acute myocardial infarction were treated with 40 mg isosorbiddinitrate-retard every 4 hours and additional sublingual nitroglycerine. There was a prompt improvement of hemodynamic parameters which was maintained for 24 hours: pulmonary capillary wedge pressure (PCW) decreased within 10 min from 26 +/- 5 (X +/- SEM) to 17 +/- 2 mm Hg (p less than 0.01) and mean arterial pressure from 109 +/- 7 to 98 +/- 6 mm Hg. The heart rate remained constant, and the cardiac index improved from 2.3 +/- 0.2 to 2.5 +/- 0.21/min/m2. The fall in blood pressure was dependent on the pretreatment pressure: it was significantly greater in patients with elevated blood pressure and only slight in those with a low pretreatment blood pressure. In the presented series of patients neither adverse effects or symptoms nor a critical reduction of blood pressure were observed. Combined oral treatment with isosorbiddinitrate and nitroglycerine can therefore be carried out without invasive blood pressure monitoring.
10例急性心肌梗死后严重充血性心力衰竭患者每4小时接受40毫克缓释异山梨酯治疗，并加用舌下含服硝酸甘油。血流动力学参数迅速改善，并维持24小时：肺毛细血管楔压（PCW）在10分钟内从26±5（X±SEM）降至17±2毫米汞柱（p＜0.01），平均动脉压从109±7降至98±6毫米汞柱。心率保持恒定，心脏指数从2.3±0.2提高到2.5±0.2升/分钟/平方米。血压下降取决于治疗前的血压：血压升高的患者下降幅度明显更大，而治疗前血压低的患者下降幅度较小。在本系列患者中，未观察到不良反应或症状，也未出现血压的严重降低。因此，联合口服异山梨酯和硝酸甘油治疗无需有创血压监测。
