[Hemodynamic action of isosorbide-5-mononitrate during rapid venous administration in patients with acute myocardial infarct].

20 patients with acute myocardial infarction were catheterized with a balloon thermodilution catheter and the hemodynamic changes following a rapid i.v. administration of 10 mg of isosorbide-5-mononitrate were studied up to the 4th hour. The drug causes a fall of the left ventricular filling pressure with 20%, of the arterial pressure with 5%, of the cardiac index with 9%, of the stroke index and of the stroke driving index and a slight increase of the systemic arterial vascular resistance without influencing the cardiac rate and the total pulmonary-vascular resistance. The drug action begins immediately, it is best expressed between the 3d and 30th minute and lasts 1-2 h. The hemodynamic changes are unidirectional in patients with left ventricular filling pressure below and above 1.9 kPa. The i.v. administration of isosorbide-5-mononitrate is indicated in the treatment of acute left cardiac failure in patients with acute myocardial infarction for the rapid reduction of pulmonary congestion and is suited for patients with a tendency toward arterial hypotension.