[Hemodynamic effect of subchronic therapy with 120 mg isosorbide dinitrate in a slow release form in minimal to moderate post-infarct heart failure].
In 16 patients (12 male, 4 female; age 48-73 years, mean = 62.2 years) with left heart failure NYHA Class II-III after myocardial infarction hemodynamic measurements by Swan-Ganz-Catheterization were performed before and after a 3-week therapy with a single dose of 120 mg ISDN in slow-release form. No patient received vasodilators and surgical revascularization was not indicated. Hemodynamics were measured before, 2 and 10 h after ISDN at rest and during exercise. Both before (rest/exercise: LVFP = 18.9 +/- 8.1 +/- 8.1/31.2 +/- 10.5 mmHg) and after 3 weeks (20.6 +/- 8.9/33.1 +/- 14.4 mmHg) ISDN significantly reduced LVFP 2 h (12.1 +/- 5.9/19.0 +/- 10.1 and 11.7 +/- 5.8/20.5 +/- 10.4 after 3 weeks) and 10 h (12.2 +/- 4.6/23.5 +/- 11.0 and 13.0 +/- 3.8/25.8 +/- 11.7 mmHg after 3 weeks) after application. No significant changes of heart rate were observed. In a subgroup of patients hemodynamic control after a 1-year treatment with 120 mg ISDN revealed a sustained reduction of LVFP at rest and during exercise. There is no significant evidence for the development of nitrate tolerance using this treatment regimen in chronic left heart failure.