Circulation, Vol 57, 732-738, Copyright © 1978 by American Heart Association
T Mann, PF Cohn, LB Holman, LH Green, JE Markis and DA Phillips
The effect of nitroprusside on regional myocardial specific blood flow
(RMBF) was evaluated in 25 patients with the xenon-133 washout technique.
Six patients were normal (group 1), six patients had coronary artery
disease without collateral vessels (group 2), and thirteen patients had
coronary artery disease with collateral vessels (group 3). In group 1, RMBF
was unchanged following nitroprusside. RMBF decreased significantly in both
group 2 and group 3, including seven patients in group 3 with high-grade
collateral vessels. The results were compared to the effect of
nitroglycerin in 31 patients previously studied using the same technique.
Mean arterial pressure and pressure- rate product were comparably reduced
by both drugs. In contrast to the findings with nitroprusside, after
sublingual nitroglycerin RMBF decreased markedly in normals and increased
in patients with coronary artery disease and high-grade collaterals. The
data suggest that nitroprusside may primarily affect resistance vessels
within the coronary circulation, as opposed to the effect of nitroglycerin
on conductance vessels. Thus, nitroprusside could result in redistribution
of blood flow away from ischemic areas and potentially increase ischemic
injury in some patients with coronary artery disease.
ARTICLES
Effect of nitroprusside on regional myocardial blood flow in coronary artery disease. Results in 25 patients and comparison with nitroglycerin
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