Left ventricular response to sublingual administration of nitroglycerin.

The aim of this study was to investigate whether the rapid improvement of the clinical condition of patients after administration of nitroglycerin can be documented objectively using the apexcardiogram. The study was performed on 28 male patients with coronary heart disease whose clinical condition allowed us to perform the initial polygraphic examination during an attack of angina pectoris. The heart rate and three apexcardiographic indexes were determined from non-invasive polygraphic tracings. The first index was the a/H (ratio: amplitude of apexcardiographic "a" wave to total amplitude of apexcardiogram). The second and third were the velocity of the anterior left ventricular wall motion during both isovolumic contraction (VwmC) and isovolumic relaxation (VwmR) of the left ventricle. The mean differences from initial values were calculated after 2, 4, 6 and 10 min following administration of nitroglycerin. Significant changes already occurred during the second minute after administration of nitroglycerin. All parameters remained significantly changed up to the 10th minute after this treatment. According to our results, the cardiovascular response to sublingual administration of nitroglycerin can be objectively evaluated by apexcardiography.