The Effect of lsosorbide Dinitrate on Left Ventricular Size, Wall Stress and Left Ventricular Function in Chronic Refractory Heart Failure An Echocardiographic Study

JOSEPH A. C. GOMES, M.D. CLARITA R. CARAMBAS,

M.D.

HARRIET’TE E. MORAN, R.N. MALKIAT S. DHATT, M.D. ANTONINO

H. CALON, M.D.*

ANTONIO

R. CARACTA,

M.D.

ANTHONY

N. DAMATO,

M.D.

Staten Island, New York

From the Cardiology Department, U.S. Public Health Service Hospital, Staten Island, New York. This study was presented in part at the 49th Scientific Sessions of the American Heart Association, Miami Beach, Florida, November 1976. This work was supported in part by the Bureau of Medical Services, National Heart, Lung and Blood Institute Project HL 12536-07. Requests for reprints should be addressed to Dr. Joseph A. C. Gornes, Cardiology Department, USPHS Hospital, Staten Island, New York 10304. Manuscript accepted May 18, 1978. Present address: 2905 Valley Brook Court, Kingsville. Maryland. l

794

November 1978

To determine the effect of a long-acting vasodilator isosorbide dinitrate (ID) on ventricular performance, 16 patients with refractory congestive heart failure underwent echocardiographic studies during control and for a period of 2 hours after the administration of 10 mg of sublingual ID. The effects of ID were seen in 5 to 10 minutes, reached maximum at 30 f 3 minutes lasted for 60 minutes and dissipated’thereafter. At the maximal drug effect, a significant decline in mean blood pressure (74 f 2 versus 61 f 3 mm Hg, p