Isosorbide dinitrate and exercise performance in patients with congestive heart failure.

Abstract:

:Nitrates are widely used for the management of congestive heart failure (CHF), as well as angina pectoris. In both situations, nitrates significantly increase exercise capacity. The mechanism of this beneficial effect is unclear, especially in CHF. Isosorbide dinitrate reduces pulmonary capillary wedge pressure (PCWP) after a first dose. The improvement in exercise capacity is not apparent in the short term but is evident after long-term nitrate administration. Nitrates do not affect hemodynamics at maximal exercise but do reduce PCWP during submaximal exercise in patients with CHF. This observation, in addition to increased oxygen extraction at peak exercise during nitrate administration, suggests a "training like" peripheral effect of nitrates in CHF. Lowering of PCWP by nitrates may be important, since vasodilators that do not reduce PCWP also do not improve exercise capacity in CHF. How PCWP influences exercise performance in CHF is unknown, but the mechanism may relate to effects of PCWP on pulmonary hemodynamics more than on ventilation and blood oxygenation.

journal_name

Am Heart J

journal_title

American heart journal

authors

Franciosa JA

doi

10.1016/0002-8703(85)90494-6

subject

Has Abstract

pub_date

1985-07-01 00:00:00

pages

245-50

issue

1 Pt 2

eissn

0002-8703

issn

1097-6744

pii

0002-8703(85)90494-6

journal_volume

110

pub_type

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