de Servi, Stefano

Eleuteri, Ermanno

Ghio, Stefano

Mazza, Stefano

Montemartini, Carlo

Perotti, Rubens

Specchia, Giuseppe

Elsevier - Publisher Connector 

Differences in the development of nitrate tolerance and in its reversal with N-acetylcisteine between arterial and venous vessels in man 

4.4 .- 
96.6 
Alan S. Hollister, 
Virginia Hail@, University of South Alabama, 
obile, AL. 
min at each dose in 5 class IV heart 
patients (CHF) and 5 normal (Nl) skbjects. 1.11 
subjects received a 10 ml/kg wa 
had steady-state infusions of P 
and urine flow was replaced with D5 i/2 MS i.v. 
CHF patients had higher 
vs 24+5, pcO.001) and lowe 
(294+18 vs 459 + 57 ml/min, ~~0.05) at baseline 
than Nl subjects. At the highest dose of 
infusion, plasma ANF (Nl: 1105+147, CHF: 1 
159 pg/ml P=NS) and cGP4P (Nl: 22.8~1.1, CHF: 
50.2G7.6 pmol/ml P-NS), and urinary cGW rose 
significantly. Urine flow rate increased from 
2.220.6 to 7.1k3.4 ml/min in CHF and 6.621.2 to 
25.7~6.3 in Nl (~~0.05). Sodium excretion rose 
from 1724 to 2322163 uEg/min in CHF and 211219 
to 13672179 in Nl (~~0.05) and fractional sodi- 
um excretion rose from 0.5*0.1 to 
CHF vs 0.9+0.1 to 5.8+8 an Iv1 (p 
ERPF, GFR and filtration fraction 
change. 
We conclude that vere CHF patients exhibit 
renal responses to F which are similar ih 
proportion, but reduced in absolute magnitude 
when compared with normal subjects. The renal 
changes seen in CHF are similar to those noted 
in N1 wbjects following a mild oral water 
load. 
HEMODYNAMIC BENEFIT ClF NITRATE THERAPY Ifi PATIE%fS WITH 
HEART FAILI’RE ALRFXU TREATED WPTH AKGIOTE?rlSI?; 
CONVERTIKG FKZ%E INHXBXTIOK 
Anil Hehra, Enrique Oscrzega, hvraham Shotan, Janer 
Vasquez-Johnson, Shahbudin H. Kahimtoola, 
LAC+USC Medical Cenf er, Los Ailgeles, CA 
Nitraees are co only used in ereatmene of chronic heart 
failure (CHF). However, their hemodynamic effect when 
given concomitantly eo angiotensin converting enzyme 
inhibit ior (ACEI? s has not been invesefgated. We studied 
the effect of GO mg oral isosorbide dinitrate (ISDE;) in 
11 patienes (pts) with CHF chronically treated with 
captopril (CAP) 89+32mgl day. Mearl pulmonary arterial 
(PA) e pulmonary wedge (PAW) and right atria1 (&I) 
pressures (mm Hg) were studied on CAP alone and 26 hrs 
later on CAF’+ISDN. Nemodynamic values were as follows: 
PA 
-  I_ 
CAP 3828 3720 3m 3ITz-- 
C+ISDN 38’7 3oz?0* 32?6* 33+8* 
PAW CAP 24?6 2226 2427 2527 
C+JSDh’ 24*7 16?6& 18%9* 20t9* 
RA CAP 1126 1125 1226 1225 
C+ISDN 1225 t3+3* 1024 9+4* 
Addition of ISDN to CAP resulted in no significant 
change in blood pressure (BP). 
CONCLUSIONS : I) ISDN potentdates h 
captopril on RA, PA and PAW without change in BP. 2) 
The reduction of right and left ventricular f ifling 
pressures and pulmonary hypertension demonstrates the 
therapeutic potential of mmbinaeion therapy with 
nitrates + ACE1 in pts with chronic CAF. 


file:///data/remote/core/dit/data/elsevier/pdf/5c8/aHR0cDovL2FwaS5lbHNldmllci5jb20vY29udGVudC9hcnRpY2xlL3BpaS8wNzM1MTA5NzkxOTE2MTlw.pdf

Differences in the development of nitrate tolerance and in its reversal with N-acetylcisteine between arterial and venous vessels in man

Abstract

Similar works

Full text

Available Versions

Elsevier - Publisher Connector

Elsevier - Publisher Connector