Circulation, Vol 66, 321-327, Copyright © 1982 by American Heart Association
RL Feldman, JD Marx, CJ Pepine and CR Conti
We studied the degree of coronary artery dilation resulting from increasing
doses of intracoronary nitroglycerin (NTG). Heart rate, aortic pressure and
coronary artery angiograms were recorded before and after 5-, 50-, 150- and
250-microgram doses of NTG infused into the left main coronary artery.
Coronary artery diameters were measured by a magnification angiographic
technique. After intracoronary NTG, heart rate was unchanged 2 minutes
after each dose. Mean aortic pressure was unchanged after 5 microgram (NS),
but declined 5 mm Hg (mean) after 50 microgram, 9 mm Hg after 150 microgram
and 18 mm Hg after 250 microgram (all p less than 0.05) compared with
before NTG. The maximal increase in diameter occurred after 150 microgram,
and no additional increase was seen after 250 microgram. After 5- and
50-microgram doses, 67% and 75% maximal dilation responses, respectively,
were observed. Compared with coronary artery diameter before NTG, the
150-microgram dose increased the diameter of left main coronary artery by
5%, proximal coronary artery segments by 9%, middle segments by 19%, distal
segments by 34%, collateral-filled coronary arteries by 38%, coronary
artery stenoses by 5%, and small coronary arteries (0.4-1.0 mm) by 54%.
These data indicate that relatively small doses of intracoronary NTG
produce potentially important coronary artery dilation without important
changes in heart rate and aortic pressure. These observations should prove
helpful in choosing dosage schedules for intracoronary NTG.
ARTICLES
Analysis of coronary responses to various doses of intracoronary nitroglycerin
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