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Objective@#To investigate the effect of isosorbide mononitrate (ISMN) targeted nanoparticles on inflammatory factors of sinusitis by establishing a rabbit model of rhinosinusitis.@*Methods@#Thirty healthy rabbits, male and female, weighing 2.5-3.5 kg, were randomly divided into 6 groups with 5 rabbits in each group. Group A was the control group. The model of rabbit sinusitis was established in group B to F, and CT was used to confirm the model was successful. After placing tubes into the maxillary sinus in the group C to F, saline, 45 mg/ml ISMN, 45 mg/ml ISMN nanoparticles and 45 mg/ml ISMN targeted nanoparticles were used to wash the maxillary sinus, respectively. Blood samples were collected from the ear vein of rabbits on day 7, 14, 21, 28, 35 and 42 after modeling respectively. Changes in the expression levels of inflammatory factors in rabbits during the modeling process and after drug washing were detected by ELISA. After the drug intervention, the maxillary sinus mucosa was taken for real-time quantitative PCR to detect the changes in the mRNA level of inflammatory factors. SPSS 22.0 software was used to process the data.@*Results@#Rabbit model of sinusitis was successfully established. ELISA showed that after the action of ISMN targeted nanoparticles of 1 week (42th day after modeling), the levels of (interleukin, IL) 4, IL-8, IL-17A and interferon γ (IFN-γ) in the blood were lower compared with that of 35th day after modeling, the difference was statistically significant (5.57±1.20 vs 19.73±0.68, 66.41±11.87 vs 154.68±13.13, 17.96±1.87 vs 28.23±0.80, 53.56±5.66 vs 111.93±7.29, all P<0.05). Compared with the ISMN nanoparticles and ISMN, the ISMN targeted nanoparticles reduced the levels of IL-4, IL-8, IL-17A and IFN-γ more obviously, the differences were statistically significant (13.26±1.43 vs 8.81±1.33 vs 7.14±2.16, 89.47±17.80 vs 41.07±7.77 vs 15.84±3.72, 10.28±2.07 vs 3.06±1.62 vs 1.82±0.90, 62.16±6.18 vs 35.12±4.62 vs 27.89±10.18, all P<0.05). Real-Time PCR showed that after the flushing of ISMN targeted nanoparticles, the levels of IL-4, IL-8, IL-17A and IFN-γ mRNA were lowest compared with that of the model group, ISMN nanoparticles and ISMN group.@*Conclusion@#ISMN targeted nanoparticles can reduce the level of inflammatory factors in rabbit sinusitis model.
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Objective To observe the clinical effect of isosorbide mononitrate combined with metoprolol in the treatment of coronary heart failure.Methods From January 2015 to May 2017,100 patients with coronary heart failure treated in the Second People's Hospital of Yuyao were randomly divided into two groups according to the digital table,with 50 cases in each group.The conventional group was treated with conventional therapy.The observation group was treated with isosorbide mononitrate combined with metoprolol on the basis of conventional treatment for 30 days.The clinical efficacy,cardiac function index and plasma BNP level were compared between the two groups.Results The total effective rate of the observation group was 96.0％ (48/50),which was higher than 78.0％ (39/50) in the conventional group(x2 =7.161,P ＜ 0.01).After treatment,the cardiac drainage index(CI) [(3.14 ± 0.53) L · min-1 · (m2)-1],cardiac output blood volume (CO) [(5.62 ± 0.95) L/min],each stroke volume (SV) [(79.24 ± 2.56) mL],left ventricular ejection fraction (LVEF) [(61.62 ± 4.95) ％] in the observation group were better than those in the conventional group[(2.41 ±0.45) L · min-1 · (m2)-1,(4.79 ± 0.23) L/min,(72.30 ± 2.78)mL,(53.79 ±4.23)％,t =7.043,5.696,12.318,8.066,all P ＜0.05].The BNP level of the observation group was (172.17 ± 10.36) pg/mL,which was lower than (215.47 ± 12.48) pg/mL of the conventional group (t =17.908,P ＜ 0.05).Conclusion The treatment of coronary heart failure with isosorbide mononitrate and metoprolol can improve the clinical effect and improve cardiac function.
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Objective@#To explore the clinical effect of Ginkgo biloba capsule combined with isosorbide mononitrate in the treatment of angina pectoris of coronary heart disease.@*Methods@#From April 22, 2017 to April 22, 2018, 100 patients with coronary heart disease and angina pectoris admitted to Zhoushan Traditional Chinese Medicine Hospital were enrolled in the study.Fifty patients in the control group were treated with isosorbide mononitrate.Fifty patients in the observation group were treated with Ginkgo biloba capsules and isosorbide mononitrate.The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), duration of angina pectoris, frequency of angina attacks, total effective rate, incidence of adverse reactions, angina relief time were observed.@*Results@#The LVEDD, LVESD, LVEF, total effective rate, incidence rate of adverse reaction, duration of angina pectoris, angina pectoris frequency and angina pectoris remission time in the observation group were (48.41±2.23)mm, (30.89±1.12)mm, (56.55±5.87)%, 96.00%, 4.00%, (3.44±1.52)min/time, (1.36±0.54)times/week, (3.12±0.56)min, respectively, which were better than those in the control group [LVEDD (64.78±2.89)mm, LVESD (42.21±1.55)mm, LVEF (43.46±1.52)%, total effective rate (74.00%), incidence rate of adverse reactions (28.00%), duration of angina pectoris (5.68±1.66)min/time, frequency of angina pectoris (2.68±1.47)times/week, angina relief time (4.87±1.41)min] (t=19.546, 41.857, 15.264, χ2=9.490, 10.714, t=7.037, 5.960, 8.156, all P<0.05).@*Conclusion@#Ginkgo biloba capsule combined with isosorbide mononitrate is effective in the treatment of patients with coronary heart disease and angina pectoris.
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OBJECTIVE： To study the effects of Dengzhan shengmai capsules combined with isosorbide mononitrate on serum TIMP-1 and MMP-9 levels， blood lipid level and cardiac function in patients with unstable angina pectoris （UAP）. METHODS： Totally 198 UAP patients admitted to our hospital from Apr. 2016 to Apr. 2019 were selected， and divided into observation group （n＝102） and control group （n＝96） according to therapy plan. Control group received Isosorbide mononitrate tablets 40 mg， qd， orally； observation group additionally received Dengzhan shengmai capsules， 2 capsules per time， tid， orally， on the basis of control group. Both groups received treatment for consecutive 4 weeks. The clinical efficacy， serum levels of MMP-9 and TIMP-1， blood lipid indexes [low density lipoprotein cholesterol （LDL-C）， high density lipoprotein cholesterol （HDL-C）， triglyceride （TG）， total cholesterol （TC）]， cardiac function indexes [end-diastolic volume （EDV）， left ventricular ejection fraction （LVEF）， end-systolic volume （ESV）] and ADR were compared between 2 groups. RESULTS： The total response rate of observation group was significantly higher than control group （91.18％ vs. 70.83％， P＜0.05）. Before treatment， there was no statistical significance in the levels of ESV， MMP-9， TIMP-1， TC， LDL-C， TG， HDL-C， EDV and LVEF between 2 groups （P＞0.05）. After treatment， the levels of MMP-9， TC， LDL-C， TG， ESV and EDV in 2 groups were decreased significantly in both groups， and the observation group was significantly lower than the control group （P＜0.05）； meanwhile， the levels of TIMP-1， HDL-C and LVEF in 2 groups were increased significantly， and the observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of total ADR in 2 groups （P＞0.05）. CONCLUSIONS： Dengzhan shengmai capsules combined with isosorbide mononitrate show good clinical efficacy for UAP， which can effectively reduce serum MMP-9 level and increase serum TIMP-1 level， reduce blood lipid levels， as well as improve cardiac function for UAP patients， with good safety.
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Objective To explore the clinical effect of Ginkgo biloba capsule combined with isosorbide mononitrate in the treatment of angina pectoris of coronary heart disease .Methods From April 22,2017 to April 22, 2018,100 patients with coronary heart disease and angina pectoris admitted to Zhoushan Traditional Chinese Medicine Hospital were enrolled in the study.Fifty patients in the control group were treated with isosorbide mononitrate.Fifty patients in the observation group were treated with Ginkgo biloba capsules and isosorbide mononitrate .The left ventricular end －diastolic diameter ( LVEDD), left ventricular end －systolic diameter ( LVESD), left ventricular ejection fraction (LVEF),duration of angina pectoris ,frequency of angina attacks ,total effective rate,incidence of adverse reactions, angina relief time were observed.Results The LVEDD, LVESD, LVEF, total effective rate, incidence rate of adverse reaction,duration of angina pectoris ,angina pectoris frequency and angina pectoris remission time in the observation group were (48.41 ±2.23)mm,(30.89 ±1.12)mm,(56.55 ±5.87)%,96.00%,4.00%, (3.44 ±1.52)min／time,(1.36 ±0.54)times／week,(3.12 ±0.56) min,respectively,which were better than those in the control group [LVEDD (64.78 ±2.89) mm,LVESD (42.21 ±1.55) mm,LVEF (43.46 ±1.52)%,total effective rate (74.00%), incidence rate of adverse reactions ( 28.00%), duration of angina pectoris (5.68 ± 1.66)min／time,frequency of angina pectoris (2.68 ±1.47)times／week,angina relief time (4.87 ±1.41)min] (t＝19.546,41.857,15.264,χ2 ＝9.490,10.714,t＝7.037,5.960,8.156,all P＜0.05).Conclusion Ginkgo biloba capsule combined with isosorbide mononitrate is effective in the treatment of patients with coronary heart disease and angina pectoris.
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Objective To investigate the effect of isosorbide mononitrate on the levels of NO,iNOS,IL-1 and IL-6 in lung tissue of spontaneously hypertensive rats (SHR).Methods Fourteen-week-old Wistar and SHR male rats were randomly divided into the W0,W1,S0 and S1 group,with 10 rats ineach group.Rats in the W0 and S0 group were fed with the normal saline and the ordinary food,rats in the W1 and S1 group were fed with isosorbide mononitrate and the ordinary food.Twelve weeks later,levels of NO,iNOS,IL-1 and IL6 in rat lung tissue were detected.Results Compared with the W0 group,levels of NO,iNOS,IL-1 and IL6 were significantly increased in the W1 groups (P ＜ 0.05,respectively).Compared with the SO group,levels of NO,iNOS,IL-1 and IL6 were significantly increased in the S1 group (P ＜ 0.05,respectively).In the W1 and S1 group,levels of iNOS and NO were positively correlated with IL-1 and IL-6.Conclusion 1.Isosorbide mononitrate may lead to increases of NO,iNOS,IL-1 and IL6 in lung tissue of Wistar rats,which indicates the presence of chronic inflammation.2.Longterm feeding of isosorbide mononitrate may lead to increases of inflammatory factors in SHR rats,contributing to the inflammatory state in rats.
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Objective:To observe the clinical efficacy and safety of Sofre injection combined with isosorbide mononitrate in the treatment of refractory heart failure. Methods:Totally 66 cases of patients with refractory heart failure in our hospital were randomly di-vided into the observation group and the control group with 33 cases in each. Each patient received the conventional treatment. On the basis of routine treatment, the control group was treated with isosorbide mononitrate injection (25mg,qd,ivd). On the basis of control group, the observation group was treated with Sofre injection (10ml, qd, ivd). The treatment course was 14 days. Before and after the treatment, the improvement degree clinical symptoms, left ventricular ejection fraction ( LVEF) , left ventricular end diastolic diameter (LVEDD), cardiac index (CI), stroke volume (SV) and 6-min walking distance (6MWD) were observed, and the rate of heart fail-ure hospitalization, heart failure mortality and 6MWT changes were followed up for 6 months in the two groups. The adverse drug reac-tions ( ADR) in both groups during the treatment were recorded as well. Results:After the 2-week treatment, the effective rate and the total effective rate of the observation group were significantly higher than those of the control group (P<0. 05); LVEF, CI, SV and 6MWD of the two groups after the treatment were significantly higher than those before the treatment, and LVEDD significantly de-creased (P<0. 05), and the improvement of the observation group was more obvious than that of the control group (P<0. 05). After the 6-month follow-up, 6MWD was significantly longer in the observation group than that in the control group (P<0. 05), while there were no statistically significant differences in the hospitalization rate and the mortality rate between the groups (P>0. 05). There were no adverse reactions in both groups during the whole treatment. Conclusion:Sofre injection combined with isosorbide mononitrate can significantly improve cardiac function in the patients with refractory heart failure with improved clinical efficacy and good safety.
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Objective To observe the influence of insulin resistance(IR) and isosorbide mononitrate(ISMN) on myocardial cellular apoptosis in spontaneously hypertensive rats (SHR) .Methods Forty male 14‐week old Wistar(W) rats and SHR(S) each were respectively or jointly fed with normal diet (ND) ,high fat and high glucose(HFHG) diet ,normal saline(NS)and ISMN by ga‐vage .Then they were randomly divided into the normal and NS group (normal W and normal S ) ,HFHG and NS group(HFHG W and HFHG S) ,normal and ISMN group(ISMN W and ISMN S) ,HFHG and ISMN group(HI W and HI S) ,with 10 rats in each group .After 12‐week feeding ,carotid arterial blood was collected for detecting blood glucose concentration and insulin level and cal‐culating insulin resistance index (HOMA‐IR);4 myocardial tissue samples were taken for respectively observing the morphology under microscope ,and detecting the NO level ,myocardial Bcl‐2 ,Bax gene and their protein expression levels in myocardial tissue . Results Myocardial NO level ,Bax gene mRNA and related protein levels in the HFHG and ISMN intervention groups were higher than those in the normal group ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;myocardial tissue NO level ,Bax gene mRNA and related protein expression in the S groups were increased compared with the corresponding W groups ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;in the HFHG W group ,the myocardial tis‐sue NO level had significantly positive correlation with HOMA‐IR ,and in the ISMN W group ,HOMA‐IR was positively correlated with the NO level in the myocardial tissue .Conclusion Myocardial cellular apoptosis of SHR is increased compared with Wistar rats ;both IR and ISMN can aggravate the apoptosis of SHR myocardial cells ,moreover IR has a mutual induction and reciprocal causation with ISMN .
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Objective To determine the protective effect of isosorbidemononitrate (IM) on myocardial injury after restoration of spontaneous circulation (ROSC)in swine models of cardiac arrest induced by ventricular fibrillation.Methods The experiment was carried out in Animal Lab of Beijing Chao-Yang Hospital,Capital Medical University.Ventricular fibrillation was induced and untreated for 8 min in twenty WhuZhiShan piglets.CPR was performed until ROSC occurred.The animals were randomized (random number)into two groups:IMgroup (n =10)and control group (n =10).IM [2 μg/(kg· min)]or the equivalent volume in saline was administered respectively for 6 h after ROSC.Hemodynamics and post-resuscitation cardiac function were monitored until 24 h after ROSC. Echocardiography and transmission electron microscopy were useed at 72 h after ROSC.Results There was no significant difference in survival rate between the two groups.No significant differences in mean arterial pressures (mmHg)at ROSC 6 h (88.5 ±5.6 vs.87.8 ±6.0,P =0.790)and ROSC 24 h (89.3 ±3.8 vs.86.9 ± 5.0,P =0.245)between the two groups were found.Cardiac outputs (L/min)were significantly increased at ROSC 6 h (2.40 ±0.17 vs.1.60 ±0.14,P <0.01)and ROSC 24 h (2.49 ±0.17 vs.2.09 ±0.21,P<0.01);and ejection fraction at ROSC 72 h (0.67 ±0.08 vs.0.56 ±0.09,P =0.044)was improved too,and significant differences were found between the two groups.The ultra-structural myocardial injury was ameliorated in the MI group at 72 h after CPR observed by using electron microscopy.Conclusions IM can ameliorate post-resuscitation cardiac dysfunction in porcine models of cardiac arrest induced by ventricular fibrillation.
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@#The aim of the study was to investigate the effect of oleic acid(OA)and isosorbide mononitrate(ISMN)on the phase diagrams of glyceryl monooleate(GMO)liquid crystalline systems and release of ISMN from them. Liquid crystalline systems of GMO/H2O, GMO/H2O/ISMN and GMO/H2O/OA were prepared and their phase diagrams were plotted. Investigation of water absorption of GMO and ISMN release profiles shown that the release mechanism of ISMN was diffusion-controlled. Increased drug loading accelerated the release rate. However, the increased loading of OA decreased ISMN release. The result could offer practical basis for drug loading and the selection of additives in GMO liquid crystalline system.
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Objective:To prepare compound isosorbide mononitrate sustained-release capsules and study the drug release. Meth-ods:Isosorbide mononitrate pellets were prepared by the fluidized bed coating technology. The influencing factors in the preparation process were examined and the major factors were optimized by single factor experiments. The drug release was determined by HPLC. The best formula was screened by optimizing aspirin coating solution. Results:The compound isosorbide mononitrate sustained-release capsules were prepared by the best formula. Both the two drugs could achieve promising release, and in vitro release behavior of isosor-bide mononitrate was fitted Higuchi equation,which was similar to that of the imported preparations. The release of aspirin in acidic and alkaline media was in coincidence with the release requirements. Conclusion:The formula is reasonable and the preparation process is stable with promising sustained release property.
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Objective To investigate the pro-angiogenesis mechanism of isosorbide mononitrate by observeing its effect on the angiogenesis in Tg(flk1:EGFP) transgenic zebrafish. Methods The embryos incubated with isosorbide mononitrate (100, 300, 500, and 1 000 μg/ml) were taken as the experiment groups, and the embryos exposed to 0. 5% DMSO were identified as the controls. The embryos were treated one hour before the postfertilization stage, and the status and length of the newly- formed blood vesseis were observed under fluorescence microscope 24-26 h after treatments. The total RNAs were extracted from zebrafish embryos at 0, 6, 12, and 24 h after treatment; real-time quantitative RT-PCR was performed to examine the ievel of Platelet-derived growth factor receptor β(PDGFRβ). Resutts Isosorbide mononitrate greatly promoted the growth of the intersegmental vessels in zebrafish (P<0. 01). It also dose-dependently promoted the growth of vascular at concentrations 100, 300, and 500 μg/ml. The expression levels of PDGFRβ gene were increased in the experiment groups compared with DMSO group, with significant difference found at 12 h and 24 h after treatment (P<0. 05, P<0. 01). Conclusion Our data suggest that isosorbide mononitrate can up-regulate PDGFRf expression and promote angiogenesis in zebrafish.
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OBJECTIVE:To evaluate the application of mixture design in the design of formulation.METHODS:Isosorbide mononitrate (ISMN) was used as model drug,and the formulation of ISMN sustained-release tablet was optimized by the mixture design.The optimized ISMN sustained-release tablets were compared with the ISMN sustained-release tablets in market in respect of the release rate in vitro.RESULTS:The comparison between the validating value and the target value of the optimized sample showed a similarity factor(f2) of 86.56,and there were no differences between the optimized sample and that in market in respect of the drug release in vitro.CONCLUSION:The mixture design is applicable for the optimization of formulation and it can be used to predict the drug release in vitro.
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OBJECTIVE:To investigate the compatible stability of isosorbide mononitrate(ISO) and dopamine(DA) hydrochloride in glucose injection.METHODS:The contents of ISO and DA in the mixture of ISO and DA at 20 ℃ and 30 ℃ under natural illumination within 24 h,and the pH and appearance of the mixture were monitored.RESULTS:No significant change was noted in the concentrations of ISO and DA,the pH and the appearance of the mixture at 20 ℃ or 30 ℃.CONCLUSION:The mixture of ISO and DA in glucose injection was stable at 20 ℃ or 30 ℃,but which should be used up within 18 h after mixing.
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@#ObjectiveTo observe the effect of nitrates and statins on blood pressure,serum lipid and artery structure of elderly patients with isolated systolic hypertension(ISH) and hyperlipidemia.Methods96 elderly patients with ISH and hyperlipidemia were randomly divided into the isosorbide mononitrate triple therapy group(group A),simvastatinelderly two drugs combination group(group B) and control group(group C) with 32 cases in each group.The group A was given isosorbide mononitrate,simvastatinelderly and felodipine.The group B was given simvastatinelderly and felodipine.The group C was given felodipine alone.The whole course lasted 12 weeks and the blood pressure,serum lipid and the change of artery structure were observed.ResultsThe effect of group A was significantly better than groups B and C(P<0.01). The effect of lowering serum lipid and change of artery intima-media thickness(IMT) in groups A and B were better than that in group C(P<0.05).ConclusionNitrates can decrease systolic blood pressure and pulse pressure,but has less effect on diastolic blood pressure.Statins can decrease IMT of the common arteries.The combination of nitrates and statins is speculated beneficial to elderly with ISH.
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OBJECTIVE:To evaluate the cost-effectiveness of different slow-release isosorbide mononitrate preparations in the treatment of coronary heart disease.METHODS:The random open study,three factors crossover trial and own control clinical test were conducted on3different Isosorbide mononitrate preparations.Then the curative effects of each were observed and the cost-effectiveness analyses were conducted.RESULTS:For the three kinds(A,B and C)of slow-release isosorbide mononitrate capsule,their total effective rates were87.9%,69.7%and57.6%respectively;the average daily medical expenses of which were10.25,15.14and14.04respectively;their cost-effectiveness ratio were69.97,130.33and146.25yuan respectively.CONCLUSION:The cost-effectiveness of the slow-release isosorbide mononitrate preparations is superior to the control medicines in the treatment of coronary heart disease.
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BACKGROUND/AIMS: Hemorrlmge from esophageal varices is a catastrophic complication of portal hypertension. Sclentherapy and/or pharmacological reatment have been used in the primary and secondary pevention of hemorrhages in high-risk cirrhotic patients. We compared the efficacy of propranolol with the efficacy of propranolol plus isosorbide mononitrate plus metoclopramide for the prevention of variceal rebleeding METHODS: Forty-six hospitalized patients with cirrhosis and bleeding from esaphageal varices were treated with mhscopic sclerotherapy and randomly assigned to treatment with propranolol (25 patients: group 1) or propranolol plus isosorbide-5-mononitrate plus metoclopramide (21 patients: group 2). The primary outcomes were rebleeding and death. RESULTS: Base-line data were similar in the two groups, and the median follow-up was 15.4 months. Seventeen (68%) of 25 patients in group 1 and 11 (52%) of 21 patients in group 2 had repeated bleeding from varices during the follow-up period, but thae were no significant statistical differences between two groups. 1 he 2-year survival rate of both poups were 56% (14/25) in poup 1 and 62% (13/21) in group 2 during follow-up period. The causes of death in both groups wererebleeding (6/11: group 1 vs 3/8: group 2), hepatic failure (3/11: group 1 vs 3/8: group 2), and hepatoma (1/11: group 1 vs 1/8: group 2). CONCLUSIONS: Propranolol plus isosorbide mononitrate plus metoclopramide triple therapy did not differ from propranolol monotherapy in the aspects of rebleeding and survival in patients with esophageal variceal bleeding after endoscopic sclerotherapy, although the former revealed the tendency of the decrease in rebleeding and mortality rate.
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Humans , Carcinoma, Hepatocellular , Cause of Death , Esophageal and Gastric Varices , Fibrosis , Follow-Up Studies , Hemorrhage , Hypertension, Portal , Isosorbide , Liver Failure , Metoclopramide , Mortality , Propranolol , Sclerotherapy , Survival Rate , Varicose VeinsABSTRACT
PURPOSE--To evaluate the acute effects of isosorbide mononitrate on circulation, cardiac function and left ventricular segmental motility in patients with isquemic heart disease due to coronary artery disease. METHODS--Twenty-four patients with ischemic heart disease, 10 women, with mean age of 58 years, were studied during cardiac catheterization, at baseline condition and 5min after intravenous infusion of 0.3mg/kg of isosorbide mononitrate. RESULTS--After infusion of isosorbide mononitrate there were significant reduction in mean right atrial pressure no mean pulmonary artery pressure (< 0.0001), left ventricular and diastolic pressure (p < 0.004), left ventricular systolic pressure (p < 0.002), maximum (p < 0.002) and mean (p < 0.008) aortic pressure, and left ventricular systolic volume (p < 0.004), as well as significant increase in the left ventricular ejection fraction (p < 0.001) and mean velocity of circunferential fibers shortening (p < 0.001). There was no significant modification of minimum aortic pressure, heart rate, cardiac output nor of left ventricular and diastolic volume. With respect of segmental motility of the left ventricle after medication, 38 kypokinetic segments normalized their motility, 4 akinetic segments remained intact, and of the 21 dyskinetic segments, 6 normalized, 8 became hypokinetic and 7 remained dyskinetic. CONCLUSION--Isosorbide mononitrate, when used as intravenous infusion, have a rapid and direct effect on systemic and pulmonary circulation, and improving segmental motility and left ventricular performance in patients with impaired left ventricular motility caused by ischemic heart disease.
Objetivo − Avaliar, durante estudo hemodinâmico e cineangiocardiográfico, os efeitos agudos do mononitrato de isosorbitol, via sistêmica, sobre a circulação e presença de áreas viáveis de isquemia miocárdica, em portadores de cardiopatia isquêmica por aterosclerose coronária obstrutiva. Métodos −Foram estudados, durante estudo hemodinâmico e cineangiocardiográfico, 24 pacientes, 10 mulheres, com média de idade de 58 anos, portadores de cardiopatia isquêmica, em condições basais e 5min após infusão de 0,3mg/kg/peso de mononitrato de isosorbitol por via venosa, para avaliar os efeitos do medicamento sobre a circulação, o desempenho cardíaco e a motilidade segmentar do ventrículo esquerdo (VE). Resultados −Após o uso do medicamento, constatou-se redução significante da pressão média do átrio direito (p<0,01), da pressão média na artéria pulmonar (p<0,000), da pressão sistólica do VE (p<0,002), da pressão diastólica final do VE (p<0,0004), da pressão aórtica máxima (p<0,002), da pressão aórtica média (p<0,008), do volume sistólico final do VE (p<0,004) e aumento da fração de ejeção do VE (p<0,001) e da velocidade média do encurtamento circunferencial (p<0,001). Não houve modificação significante da pressão aórtica mínima, da freqüência cardíaca, do débito cardíaco e do volume diastólico final do VE. Quanto ao comportamento da motilidade segmentar, após o uso do medicamento, os 38 segmentos hipocinéticos normalizaram sua motilidade, os 4 segmentos acinéticos não se alteraram e, dos 21 segmentos discinéticos, 6 normalizaram, 8 se tornaram hipocinéticos e 7 não alteraram sua motilidade segmentar. Constatou-se ainda que o medicamento desenvolveu ação efetiva sobre a circulação, 30s após sua infusão. Conclusão − O mononitrato de isosorbide produziu ação rápida e efetiva sobre a circulação, a motilidade segmentar e desempenho do VE, identificando áreas viáveis com isquemia miocárdica
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Humans , Male , Female , Adult , Middle Aged , Vasodilator Agents , Isosorbide Dinitrate , Coronary Artery Disease/physiopathology , Hemodynamics/drug effects , Myocardial Ischemia/physiopathology , Aged, 80 and over , Cineangiography , Isosorbide Dinitrate , Coronary Artery Disease/complications , Cardiac Catheterization , Ventricular Function, Left/drug effects , Injections, Intravenous , Myocardial Ischemia/complicationsABSTRACT
Tho effects of native isosorbide mononitrate ( ISMN ) on the hemodynamics in rats with early myocardial infarction by left coronary artery occlusion were investigated. LVSP and dP/dtMAX were increased, and LVEDP was decreased with ISMN 5mg/kg i.v. 20 min after coronary occlusion. However, ISMN did not significantly effect the HR, SAP, DAP and MAP. The results showed that ISMN can improve cardial function in early myocardial infarction.