Effect of glyceryl trinitrate on peripheral arteries alters left ventricular hydraulic load in man.

Abstract:

:Effects of sublingual glyceryl trinitrate (GTN) were studied in ten patients without heart failure during diagnostic cardiac catheterisation following angiography. GTN caused substantial reduction in peak left ventricular and aortic pressure (19 mmHg) with lesser reduction in mean aortic pressure (9 mmHg) and no change in diastolic aortic pressure. Reduction in stroke volume (by 15%), associated with fall in left ventricular end diastolic pressure (by 4 mmHg) was insufficient to explain the marked (17 mmHg - 34%) reduction in pulse pressure. Decrease in pulse pressure was associated with loss of the late systolic peak on both the aortic and left ventricular pressure wave. This peak is caused by pulse wave reflection. GTN caused no change in peripheral resistance or in indices of aortic compliance (characteristic impedance, total arterial compliance) but was associated with reduction in fluctuations of both modulus and phase of aortic impedance. All these changes in pressure waves and in impedance spectra are explicable on the basis of decreased peripheral wave reflection. This can be attributed to the known vasodilatory effect of GTN on the peripheral arteries. Simulation of arterial vasodilatation in a multi-branched model of the systemic arterial system confirmed this interpretation. Dilatation of peripheral arteries explains in part the beneficial effects of GTN in adult man.

journal_name

Cardiovasc Res

journal_title

Cardiovascular research

authors

Yaginuma T,Avolio A,O'Rourke M,Nichols W,Morgan JJ,Roy P,Baron D,Branson J,Feneley M

doi

10.1093/cvr/20.2.153

subject

Has Abstract

pub_date

1986-02-01 00:00:00

pages

153-60

issue

2

eissn

0008-6363

issn

1755-3245

journal_volume

20

pub_type

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