[Treatment of left ventricular failure with percutaneous nitroglycerin (author's transl)].

In 12 patients aged from 45 to 75 years (mean : 62.57 +/- 8.37 years) a 2% percutaneous prepartion of nitroglycerin (PCNG) was applied on a square thoracic area measuring 15 x 15 cm, and its efficacy and duration of action were assessed by recording pressures in the right cavities and in the brachial artery. Left ventricular failure was due to recent myocardial infarction in nine cases, ischemic cardiopathy in two and non-obstructive cardiomyopathy in one. The 15 mg initial dose of PCNG was progressively increased until optimal dosage was reached. The efficacy of the drug was reflected in a significant fall in pulmonary artery diastolic pressure (PADP), equivalent to the mean capillary pressure, from 21.8 +/- 7.9 to 12.75 +/- 8.6 mmHg (p < 0.001). The mean systemic arterial pressure was reduced from 92.2 +/- 17.4 to 83 +/- 16.7 mmHg (P < 0.01). The cardiac index rose from 2.7 +/- 1 to 2.8 +/- 0.51/mn/m2 (N.S.) and the systolie index from 30.1 +/- 12.7 to 31.7 +/- 9.1 ml/systole/m2 (N.S.). Changes in PADP were significant (p < 0.05) during six hours and maximal at two hours (p < 0.001). There was a good correlation (r = 0.68 ; p < 0.02) between the time required to return to the initial values and the optimal fall in PADP. This shows that PCNG is undoubtedly long-acting in left ventricular failure, provided the doses are sufficient to induce a marked decrease in PADP.