Hemodynamic Effect of Nicorandil into Pulmonary Artery in Coronary Artery Disease

BACKGROUND AND OBJECTIVES: Nicorandil has pharmacologic effects similar to nitroglycerin and potassium in respect to the channel opening action in vascular smooth muscle cells. We examined hemodynamic changes in patients following nicorandil infusion. We investigated the action mechanism of nicorandil, and whether nicorandil affects hemodynamic changes in patients receiving antianginal medication. SUBJECTS AND METHODS: A total of 17 patients (11 normal control group, 6 coronary artery disease group) undergoing cardiac catheterization for investigation of chest pain participated in this study. During cardiac catheterization, nicorandil was infused into the pulmonary artery at a dose of 80 microgram/kg over a period of 1 min. Hemodynamic parameters were measured before and at 5, 10 and 20 minutes after nicorandil infusion. RESULTS: Five minutes after nicorandil infusion, the maximal changes in preload and afterload hemodynamic parameters were observed in both the coronary artery disease and control group. Changes of preload parameters were sustained longer than those of afterload parameters, and were maintained until 20 minutes after the infusion. Afterload parameters (heart rate and cardiac output), were slowly normalized five minutes after the infusion. In the coronary artery disease group with antianginal medication, additive hemodynamic changes were also seen after the infusion, although the degree of changes were small. CONCLUSION: Following nicorandil infusion, both the preload and afterload hemodynamic parameters decreased, and the preload parameters showed a larger decrease for a longer period than the afterload parameters. In the coronary artery disease group with antianginal medication, additive hemodynamic changes were also seen following nicorandil infusion.

Esophageal Lead for Intraoperative Electrocardiographic Monitoring in Major Burned Patients / 대한마취과학회지

The use and safety of the esophageal electrocardiogram for detection and diagnosis of using lead ll in major burn patient, especially burn of chest and face Compared with lead ll , 100% of cardiac rhythm was properly detected with the esopha-geal electrcardiogram. Large distinct P waves, resulting from the proximity of the esophageal lead to the left atrium, clearly established the temporal relationship between atrial and ventricular depo- larization Ne complications were encountered during the atudy. The esophageal lead is safe, simple to use, and provides valuable information fur dele- ction or diagnosis of cardiac rhythm during major burn anesthesia.