Hemodynamic Effects of Combined Isosorbide Dinitrate-Nifedipine Therapy in Congestive Heart Failure Shinobu Matsui 1 , Eiji Murakami 1 , Noboru Takekoshi 1 , Hidenori Murakami 1 , Kazuhiro Masuya 1 , Masayuki Nomura 1 , Shizuka Fujita 1 , Sotoyuki Tsuji 1 , Takashi Chadani 1 1Division of Cardiology, Department of Internal Medicine, Kanazawa Medical University pp.965-970
Published Date 1981/9/15
DOI https://doi.org/10.11477/mf.1404203842
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To determine whether combined isosorbide dinitrate (ISDN)-nifedipine (NIF) therapy might be useful in the treatment of congestive heart failure, this study was designed to compare hemo-dynamic effects of ISDN and combined ISDN-NIF administration. Nine patients with class III or IV congestive heart failure as defined by the NYHA were studied. In all patients pulmonary arterial and right atrial pressure were recorded with a Swan-Ganz catheter. Cardiac output wasmeasured by thermodilution technique. After obtainning the control values of hemodynamics, 5 mg of ISDN was administrated sublingually and the 2nd hemodynamic measurement was done 20 minutes thereafter. After the 2nd measurement, 2 mg of NIF was administrated sublingually and then, the 3rd hemodynamic measurement was done 30 minutes after NIF administration. After administration of combined ISDN-NIF, mean arterial blood pressre (MABP), PAEDP, LVSWI and total systemic vascular resistance index(TSVRI) were significantlly decreased as compared with these values of control measurement. After NIF administration, CI and SVI were significant-ly increased as compared with these values of 2nd measurement. In 6 patients who showed a high PAEDP (over 18 mmHg), the fall in PAEDP was accompanied by an increase in SVI after combined ISDN-NIF administration. These results indicate that combined ISDN-NIF therapy is beneficial to treat the patients with congestive heart failure.

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