BACKGROUND: The present study was performed to evaluate the effects of nitroglycerin (GTN) on plasma arteriovenous cGMP production and to compare its hemodynamic effects in patients with congestive heart failure (CHF). We also estimated the potential clinical value of plasma arteriovenous cGMP production as an indicator of nitrate tolerance. METHODS AND RESULTS: Plasma arterial and venous cGMP levels, atrial natriuretic peptide level, and hemodynamic parameters were measured before and after GTN infusion in 14 patients with CHF. Although the plasma levels of arterial cGMP and atrial natriuretic peptide decreased immediately after GTN, the plasma level of venous cGMP did not change. GTN infusion caused a dose-dependent increase in plasma arteriovenous cGMP production, and there was a positive correlation between the decrease of pulmonary capillary wedge pressure and the increase of plasma arteriovenous cGMP production immediately after GTN. Hemodynamic tolerance was observed after both 12 and 24 hours, when plasma arteriovenous GMP production was also attenuated. CONCLUSIONS: These findings indicate that the plasma arteriovenous cGMP difference is a clinical indicator of vasodilatory action of GTN and a useful indicator of nitrate tolerance in patients with CHF.
BACKGROUND: The present study was performed to evaluate the effects of nitroglycerin (GTN) on plasma arteriovenouscGMP production and to compare its hemodynamic effects in patients with congestive heart failure (CHF). We also estimated the potential clinical value of plasma arteriovenouscGMP production as an indicator of nitrate tolerance. METHODS AND RESULTS: Plasma arterial and venous cGMP levels, atrial natriuretic peptide level, and hemodynamic parameters were measured before and after GTN infusion in 14 patients with CHF. Although the plasma levels of arterial cGMP and atrial natriuretic peptide decreased immediately after GTN, the plasma level of venous cGMP did not change. GTN infusion caused a dose-dependent increase in plasma arteriovenouscGMP production, and there was a positive correlation between the decrease of pulmonary capillary wedge pressure and the increase of plasma arteriovenouscGMP production immediately after GTN. Hemodynamic tolerance was observed after both 12 and 24 hours, when plasma arteriovenousGMP production was also attenuated. CONCLUSIONS: These findings indicate that the plasma arteriovenouscGMP difference is a clinical indicator of vasodilatory action of GTN and a useful indicator of nitrate tolerance in patients with CHF.
Authors: Luis E F Almeida; Sayuri Kamimura; Celia M de Souza Batista; Nicholas Spornick; Margaret Y Nettleton; Elizabeth Walek; Meghann L Smith; Julia C Finkel; Deepika S Darbari; Paul Wakim; Zenaide M N Quezado Journal: Nitric Oxide Date: 2019-11-02 Impact factor: 4.427
Authors: Paul M McKie; Alessandro Cataliotti; Tomoko Ichiki; S Jeson Sangaralingham; Horng H Chen; John C Burnett Journal: J Am Heart Assoc Date: 2014-01-02 Impact factor: 5.501