Summary
The effect of nitroglycerin (N.G.) on the size of myocardial infarction was studied in 12 open-chest dogs with chloralose-urethane anesthesia by means of epicardial ECG-mapping and compared with the influence of simple ligature of the same coronary artery branch. In order to identify the specific effect of N.G. on the heart and the coronary circulation without contribution of the peripheral circulation in 6 dogs aortic pressure was stabilized by a clamp placed around the descending aorta and heart rate was kept constant by atrial pacing.
Nitroglycerin (0.5 mg/kg i.v.) infused during the occlusion period of 20 min resulted in a decrease of mean arterial pressure for 27 mm Hg (p<0.005) and left ventricular enddiastolic pressure for 2 mm Hg (p<0.05) indicating a diminishment in oxygen demand. Mean coronary blood flow was reduced to a similar extent (18%) as in the control infarction (22%). Compared to simple occlusion no significant alteration in the extent of ST-elevation in the epicardial electrogram was observed during N.G.-infusion even in the presence of hypotension. In the stabilized group with constant afterload (mean arterial pressure) and heart rate nitroglycerin induced a slight, but not significant decrease of the enddiastolic left ventricular pressure compared to the control group. However, coronary blood flow and ST-elevation were unaffected. Thus, neither in the unstabilized nor in the stabilized group the extent of myocardial injury after ligature of a coronary artery branch were influenced by nitroglycerin. Obviously the improvement in the oxygen demand during nitroglycerin is out balanced by the reduction in oxygen supply so that in effect myocardial infarction size is not altered by N.G. as estimated from epicardial ECG.
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References
Bernstein, L., Friesinger, G. C., Lichtlen, P. R., Ross, R. S.: The effect of nitroglycerin on the systemic and coronary circulation in man and dogs. Myocardial blood flow measured with xenon133. Circulation 33, 107–116 (1966).
Bing, R. J., Benmish, A., Bluemchen, G., Cohnen, A., Gallagher, J. P., Zaleski, E. J.: The determination of coronary flow equivalent with coincidence counting technique. Circulation 29, 833–846 (1964).
Bing, R. J., Cowan, C., Bottcher, D., Corsini, G., Daniels, C. G.: A new method of measuring coronary blood flow in man. J. Amer. med. Ass. 205, 277–280 (1968).
Bleifeld, W., Irnich, W.: Methode zur epikardialen EKG-Registrierung. Z. Kreisl.-Forsch. (in press).
Brachfeld, N., Bozer, J., Gorlin, R.: Action of nitroglycerin on the coronary circulation in normal and mild coronary subjects. Circulation 19, 697–704 (1959).
Bretschneider, H. J.: Aktuelle Probleme der Coronardurchblutung und des Myokardstoffwechsels. Ärztl. Fortb. 15, 1 (1967).
Brunton, T. L.: On the use of nitrite of amyl in angina pectoris. Lancet 1867 II, 97.
Bussmann, W. D., Bleifeld, W., Meyer, J., Irnich, W., Effert, S.: Verkleinerung der Ischämiezone beim Herzinfarkt durch die intraaortale Ballonpulsation. Verh. dtsch. Ges. Kreisl.-Forsch. 37, 314–320 (1971).
Charlier, P.: Antianginal drugs. Handbook Exp. Pharmacol. 31, 81–83 (1971).
Detry, J. M., Bruce, R. A.: Effects of nitroglycerin on “maximal” oxygen intake and exercise electrocardiogram in coronary heart disease. Circulation 43, 155–163 (1971).
Essex, H. E., Herrich, J. F., Baldes, E. J., Mann, F. C.: Blood flow in the circumflex branch of the left coronary artery of the intact dog. Amer. J. Physiol. 117, 271–279 (1936).
Fam, W., Gregor, M. M.: Effect of coronary vasodilator drugs on retrograde flow in areas of chronic myocardial ischemia. Circulat. Res. 15, 355–365 (1964).
Frick, M. H., Balcon, R., Cross, D., Sowton, E.: Hemodynamic effects of nitroglycerin in patients with angina pectoris studied by an atrial pacing method. Circulation 37, 160–168 (1968).
Gillis, R. A., Melville, K. I.: Effects of sublingually and intravenously administered nitroglycerin on the cardiovascular system of the dog. Amer. J. Cardiol. 28, 38–42 (1971).
Gorlin, R., Brachfeld, N., McLeod, C., Bopp, P.: Effect of nitroglycerin on the coronary circulation in patients with coronary artery disease or increased left ventricular work. Circulation 19, 705–718 (1959).
Haight, C., Figley, M. M., Sloan, H., Ellsworth, W. J., Meyer, J. A., Berk, M. S., Boblitt, D. E.: Coronary arteriography. I. Controlled experimental method; II. modifications of coronary circulation. Circulation 18, 732 (1958).
Honig, C. R., Tenney, S. M., Gabel, P. V.: The mechanism of cardiovascular action of nitroglycerin. Amer. J. Med. 29, 910–923 (1960).
Jennings, R. B., Sommers, H. M., Herdson, P. A.: Ischemic injury of myocardium. Ann. N.Y. Acad. Sci. 156, 61–64 (1969).
Marchetti, G. V., Merlo, L., Antognetti, R. M.: The effects of nitroglycerin on the coronary blood flow and oxygen consumption in the anesthetized dogs. Amer. J. Cardiol. 13, 51–57 (1964).
Maroko, P. R., Kjekshuis, J. D., Sobel, B. E., Watanabe, T., Covell, J. W., Ross, J., Jr., Braunwald, E.: Factors influencing infarct size following experimental coronary artery occlusion. Circulation 43, 67–82 (1971).
Mason, D. T., Spann, J. F., Jr., Zelis, R., Amsterdam, E. A.: Physiologic approach to the treatment of angina pectoris. New Engl. J. Med. 281, 1225–1228 (1969).
Mason, D. T., Zelis, R., Amsterdam, E. A.: Actions of the nitrites on the peripheral circulation and myocardial oxygen consumption: Significance in the relief of angina pectoris. Chest 59, 296–305 (1971).
Mathes, P., Rival, J.: Effect of nitroglycerin on total and regional coronary blood flow in the normal and ischemic canine myocardium. Cardiovasc. Res. 5, 54–61 (1971).
Melville, K. J., Gillis, R. A., Sekeli, P.: Coronary blood flow, blood pressure and heart rate dose-response changes after nitroglycerin administration. Canad. J. Physiol. Pharmacol. 43, 9–18 (1965).
Raab, W.: The non vascular metabolic myocardial vulnerability factor in “coronary heart disease”. Amer. Heart. J 66, 685–706 (1963).
Raff, W. K., Drechsel, U., Scholtholt, J., Lochner, W.: Herzwirkung des Nitroglyzerins. Pflügers Arch. 317, 336–343 (1970).
Rees, J. R., Ashfield, R., Gibson, D., Gavey, C. J.: Myocardial blood flow measurement with 133xenon effect of glyceryl trinitrate in dogs. Brit. Heart J. 28, 374–381 (1966).
Schimert, G.: Die Therapie der Coronarinsuffizienz im Lichte einer neuen Betrachtung der Pathogenese. Schweiz. med. Wschr. 25, 598–603 (1951).
Strauer, B. E., Westberg, C., Tauchert, M.: Untersuchungen über inotrope Nitroglyzerinwirkungen am isolierten Ventrikelmyokard. Pflügers Arch. 324, 124–133 (1971).
Winbury, M. M.: Redistribution of left ventricular blood flow produced by nitroglycerin. Circulat. Res. 28/9, Suppl. 1, 140–147 (1971).
Winbury, M. M., Howe, B. B., Hefner, M. A.: Effects of nitrates and other coronary dilators on large and small coronary vessels: a hypothesis for the mechanism of action of nitrates. J. Pharmacol. exp. Ther. 168, 70–95 (1969).
Yabuki, S., Blanco, G., Imariglia, J. E.: Time studies of acute reversible coronary occlusions in dogs. J. thorac. cardiovasc. Surg. 38, 40–45 (1959).
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Bleifeld, W., Wende, W., Bussmann, W.D. et al. Influence of nitroglycerin on the size of experimental myocardial infarction. Naunyn-Schmiedeberg's Arch. Pharmacol. 277, 387–400 (1973). https://doi.org/10.1007/BF00500998
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DOI: https://doi.org/10.1007/BF00500998