Abstract
In order to investigate whether intravenous bolus injection of isosorbide dinitrate (ISDN) is a safe and efficient therapy in aged patients with congestive heart failure, we studied acute hemodynamic effects in 11 patients. Peak effects on preload were observed after 5 to 10 minutes of bolus injection and unloading effects continued effectively for 60 minutes. At peak effect, pulmonary systolic pressure decreased from 50.2±2.6 to 36.2±2.6mmHg (-28.5%, p<0.01) and pulmonary end diastolic pressure decreased from 25.0±2.2 to 18.5±2.1mmHg (-26.0%, p<0.01). Mean pulmonary artery wedge pressure decreased from 23.4±2.2 to 16.0±2.1mmHg (-31.6%, p<0.01). Mean right atrial pressure decreased from 10.5±1.8 to 7.4±2.0mmHg (-29.5%, p<0.01). Blood pressure, heart rate, cardiac index, systemic and pulmonary vascular resistance showed no significant changes. Thus, intravenous bolus injection of ISDN showed a potent vasodilator effects on preload, and may be a safe and useful treatment for aged patients with acute congestive heart failure.
