Henning H, Crawford M H, Karliner J S, O'Rourke R A
Am J Cardiol. 1976 Mar 31;37(4):623-9. doi: 10.1016/0002-9149(76)90405-7.
The effects of sublingually administered nitroglycerin on segmental left ventricular wall motion determined by videotracking and radiographic left heart size were evaluated at rest and during submaximal hand grip exercise in 10 patients with previous transmural myocardial infarction. After nitroglycerin, diastolic left heart size decreased in the resting state from an average of 49.5 +/- 5.7 (standard deviation) to 47.9 +/- 5.6 mm/m2 body surface area (P less than 0.01) and during handgrip exercise from a mean of 50.7 +/- 590 to 49.1 +/- 4.7 mm/m2 (P less than 0.05). In the resting state, the average maximal velocity of shortening in segments with normal wall motion increased after nitroglycerin from 18.1 +/- 3.0 to 23.5 +/- 5.5 mm/sec (P less than 0.01), whereas during handgrip exercise alone, the velocity of shortening averaged 25.6 +/- 6.9 mm/sec and increased further after nitroglycerin to 30.1 +/- 10.6 mm/sec (P less than 0.05). The effects of nitroglycerin on the average extent of shortening in normal segments were similar. In all 10 patients, there was a decrease in the number of segments with abnormal wall motion. The number of sites with dyssynergy decreased after nitroglycerin from 24 to 15 in the resting state and from 40 to 22 when nitroglycerin was administered before handgrip exercise. Sublingually administered nitroglycerin appears to decrease left heart size, increase the velocity and extent of shortening in normal left ventricular segments and often reduce the extent of left ventricular wall motion abnormalities at rest and during isometric exercise in patients with previous transmural myocardial infarction.
在10例既往有透壁性心肌梗死的患者中，评估了静息状态下以及次极量握力运动期间，舌下含服硝酸甘油对通过视频追踪测定的节段性左心室壁运动和X线左心大小的影响。含服硝酸甘油后，静息状态下舒张期左心大小从平均49.5±5.7（标准差）降至47.9±5.6mm/m²体表面积（P<0.01），握力运动期间从平均50.7±5.90降至49.1±4.7mm/m²（P<0.05）。在静息状态下，壁运动正常节段的平均最大缩短速度在含服硝酸甘油后从18.1±3.0增至23.5±5.5mm/秒（P<0.01），而仅在握力运动期间，缩短速度平均为25.6±6.9mm/秒，含服硝酸甘油后进一步增至30.1±10.6mm/秒（P<0.05）。硝酸甘油对正常节段平均缩短程度的影响相似。在所有10例患者中，壁运动异常的节段数量均减少。不协调部位的数量在含服硝酸甘油后，静息状态下从24个降至15个，在握力运动前含服硝酸甘油时从40个降至22个。舌下含服硝酸甘油似乎可减小左心大小，增加正常左心室节段的缩短速度和程度，并常常减少既往有透壁性心肌梗死患者在静息状态下和等长运动期间左心室壁运动异常的程度。
