Robert Zellis, M.D.; Dean T. Mason, M.D., F.A.C.P.; James F. Spann, M.D.; Ezra A. Amsterdam, M.D.
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Since it now is considered that nitroglycerin does not appreciably increase blood flow in sclerotic coronary arteries, studies were undertaken to determine whether nitroglycerin significantly alters the three principal factors that determine myocardial oxygen consumption (MVo2):  myocardial contractility;  heart rate; and  myocardial wall tension, which is affected by venous tone (preload) and peripheral arteriolar resistance (afterload). In four isolated cat papillary muscles, nitroglycerin (10µg/100 ml) and sodium nitrite (5 mg/100 ml) did not alter the maximum contractile element velocity and thus do not work clinically to decrease MVo2 by diminishing contractility. In contrast, 0.9 mg sublingual nitroglycerin
Zellis R, Mason DT, Spann JF, et al. The Mechanism of Action of Nitroglycerin in the Relief of Angina Pectoris: Reduction of Myocardial Oxygen Requirements by Extracoronary Vasodilation and Its Attenuation by the Chronic Administration of lsosorbide Dinitrate.. Ann Intern Med. 1970;72:779. doi: https://doi.org/10.7326/0003-4819-72-5-779_2
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Published: Ann Intern Med. 1970;72(5):779.
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