心室中隔欠損作成犬における硝酸イソソルビトール静注の血行動態に及ぼす影響

Effects of isosorbide dinitrate intravenation on hemodynamics in the dog with experimental ventricular septal defects

　従来より心不全の治療にはジギタリス剤，カテコールアミン類および利尿剤が使用されてきたが，近年主として内科領域での重症心不全に対する治療の一環として血管拡張剤が使用されるようになった^1〜4）。しかし心室中隔欠損症などの心室位左右短絡疾患において，血管拡張剤が有効であるかどうかの検討は充分なされていない。そこで著者らは，代表的な容量血管拡張剤である硝酸イソソルビトール（Nitrol,E-0291-002,H550828），（以下ISDN）の静注が，心室位左右短絡を有する血行動態に対してどのような影響を及ぼすかを知るために，心室中隔欠損作成犬を用いて検討を行ったので報告する。

This study was undertaken to determine the effects of isosorbide dinitrate (ISDN) intravenation on hemodynamics in the dog with experimental ventricular septal defects.

The results were summarized as follows.

1) Left ventricular (I.V) preload and afterload were significantly reduced by ISDN.

2) Aortic blood flow was not changed, while left-to-right shunt flow and pulmonary blood flow were reduced.

3) Both pulmonary vascular resistance and systemic vascular resistance were significantly decreased.

4) LV stroke volume and LV stroke work, when pulmonary blood flow was used as I.V output, were decreased.

5) ISDN made myocardial oxygen requirements reduced in accordance to the results that heart rate and R to dP/dt were not changed, while double product was significantly decreased.

These data indicated that ISDN intravenation improved hemodynamics in the dog with experimental ventricular septal defects.