Dubiel J P, Grodecki J, Bacior B, Mroczek-Czernecka D
I Kliniki Kardiologii AM, Krakowie.
Pol Tyg Lek. 1991;46(22-23):406-8.
An effect of isosorbide dinitrate on blood pressure values in the pulmonary circulation and the right heart has been investigated in 25 patients with a history of the first transmural myocardial infarction. Group I including 12 patients has been given 5 mg isosorbide nitrate in a 60-minute intravenous infusion while group II of 13 patients has been given 10 mg of the drug in the same way. Both groups have been matched in clinical data and blood pressure value in the pulmonary circulation which has been normal. Pulmonary blood pressure has been measured with Swan-Ganz catheter prior to the administration of drug, and 15, 30, 45 and 60 minutes following an infusion. Isosorbide dinitrate in a dose of 5 mg did not decrease blood pressure in the pulmonary circulation statistically significantly. The differences in blood pressure falls did exceed 9%. Filling pressure in the right ventricle did not change either while systolic blood pressure decrease by 16.6%. A double dose of isosorbide dinitrate reduced blood pressure in the pulmonary artery by about 1/3 of the baseline value, and blood pressure in the right ventricle (mean right atrial pressure) by 57.2%. Both systolic and diastolic arterial pressures were reduced. Isosorbide dinitrate reduced blood pressure in the pulmonary circulation in patients who underwent myocardial infarction, and hypotensive effect has been dose-related. A reduction in the right ventricular filling pressure has been a one of important mechanisms decreasing pulmonary pressures.
对25例有首次透壁性心肌梗死病史的患者，研究了硝酸异山梨酯对肺循环血压值和右心的影响。第一组12例患者接受了60分钟静脉输注5毫克硝酸异山梨酯，而第二组13例患者以同样方式接受了10毫克该药物。两组在临床数据和肺循环血压值方面进行了匹配，肺循环血压值均正常。在给药前以及输注后15、30、45和60分钟，用Swan-Ganz导管测量肺血压。5毫克剂量的硝酸异山梨酯在统计学上并未显著降低肺循环血压。血压下降的差异未超过9%。右心室充盈压也没有变化，而收缩压下降了16.6%。双倍剂量的硝酸异山梨酯使肺动脉血压降低了约基线值的1/3，右心室血压（平均右心房压）降低了57.2%。收缩压和舒张压均降低。硝酸异山梨酯降低了心肌梗死患者的肺循环血压，且降压作用与剂量相关。右心室充盈压的降低是降低肺压的重要机制之一。
