This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mehta, J. Articles by Pepine, C. J. Search for Related Content PubMed PubMed Citation Articles by Mehta, J. Articles by Pepine, C. J.

Circulation, Vol 58, 803-807, Copyright © 1978 by American Heart Association

ARTICLES

Effect of sublingual nitroglycerin on regional flow in patients with and without coronary disease

J Mehta and CJ Pepine

We evaluated the effects of sublingual nitroglycerin on indices of regional coronary flow and coronary resistance (CR) in 12 selected patients with coronary artery disease (CAD) and eight with normal coronary arteries (NCA), using continuous thermodilution. Resting total left ventricular flow, reflected by coronary sinus flow (CSF), and anterior regional flow, reflected by great cardiac vein flow (GCVF), in NCA and CAD patient groups, were similar. However, in a subgroup of six patients, with CAD limited to the anterior descending artery, GCVF was lower and anterior regional CR (CRANT) higher than the NCA subjects. Nitroglycerin reduced the systolic pressure-heart rate product similarly in both patient groups. CSF and GCVF in NCA subjects declined 15% and 17%, respectively, as total CR (CRT) and CRANT increased. In the CAD subgroup, consisting of patients with CAD limited to the anterior descending, GCVF increased 48% as CRANT declined 50%, and CSF was unchanged. In the other CAD subgroup of patients with CAD in the right and/or circumflex arteries, GCVF declined 32% and CRANT increased 46% as CSF was minimally increased. These data imply that sublingual nitroglycerin reduces both CSF and GCVF in NCA patients as oxygen demands decrease. In certain CAD patients, however, nitroglycerin alters regional coronary venous blood flow, suggesting a redistribution of flow from normally perfused to hypoperfused regions.

This article has been cited by other articles:

				J. J. Crowley and L. M. Shapiro Noninvasive Assessment of Left Internal Mammary Artery Graft Patency Using Transthoracic Echocardiography Circulation, November 1, 1995; 92(9): 25 - 30. [Abstract] [Full Text]

				J. Abrams A Reappraisal of Nitrate Therapy JAMA, January 15, 1988; 259(3): 396 - 401. [Abstract] [PDF]

				S. Corwin and J. A. Reiffel Nitrate Therapy for Angina Pectoris: Current Concepts About Mechanism of Action and Evaluation of Currently Available Preparations Arch Intern Med, March 1, 1985; 145(3): 538 - 543. [Abstract] [PDF]

				N. L. DePace, I. M. Herling, M. N. Kotler, A-H. Hakki, S. R. Spielman, and B. L. Segal Intravenous Nitroglycerin for Rest Angina: Potential Pathophysiologic Mechanisms of Action Arch Intern Med, October 1, 1982; 142(10): 1806 - 1809. [Abstract] [PDF]