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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.
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Article info
Publication history
Accepted:
March 19,
1975
Footnotes
☆This investigation was supported in part by Research Grants HL-14196F, RR-7, and HL-4664 from the National Institutes of Health, U. S. Public Health Service, Bethesda, Md.
Identification
Copyright
© 1975 Published by Elsevier Inc.
