Regional left ventricular wall dynamics before and after sublingual administration of nitroglycerin

Jean G. Dumesnil, Erik L. Ritman, George D. Davis, Gerald T. Gau, Barry D. Rutherford, Robert L. Frye

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Abstract

Regional wall dynamics of the left ventricle before and after sublingual administration of 0.6 mg of nitroglycerin were determined from left ventricular angiograms in 27 patients undergoing coronary arteriography. Regional wall dynamics were quantitatively measured from 60/sec determinations of wall thickness and derived peak rate of systolic wall thickening (peak dTw/dt) in selected sites of the left ventricle. A total of 70 regions were studied. Analysis of the same segment before and after administration of nitroglycerin revealed that the mean change in peak dTw/dt was +1.97 cm/sec in segments with an initial peak dTw/dt of less than 5 cm/sec, in contrast to a change of +0.66 cm/sec in segments with an initial control value of 5 cm/sec or greater. Akinetic or dyskinetic areas did not show improvement after nitroglycerin. In 11 left ventriculograms, an area that was initially hypokinetic manifested an increase in rate of wall thickening after nitroglycerin. The mean increase in peak dTw/dt in anterior segments with electrocardiographic evidence of myocardial infarction was 0.18 cm/sec (P <0.05) after nitroglycerin, compared with a mean change of 1.33 cm/sec in anterior segments without such evidence. This study presents evidence for a regional myocardial response to nitroglycerin with differing responses within the same ventricle apparently depending upon the functional state of the underlying myocardium.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalThe American journal of cardiology
Volume36
Issue number4
DOIs
StatePublished - Oct 6 1975

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dumesnil, J. G., Ritman, E. L., Davis, G. D., Gau, G. T., Rutherford, B. D., & Frye, R. L. (1975). Regional left ventricular wall dynamics before and after sublingual administration of nitroglycerin. The American journal of cardiology, 36(4), 419-425. https://doi.org/10.1016/0002-9149(75)90888-7