Effects of Intravenous Isosorbide Dinitrate on Filling Pressures and Pump Function in Patients with Refractory Pump Failure

Abstract

The role of vasodilators in the therapy of pump failure has been a subject of intensive investigation. Conflicting results have been reported about the mechanism of action of nitroglycerine and of isosorbide dinitrate. Some authors (1,2,3,4) found these agents active peripherally only on the venous side of the circulation, thus merely affecting filling pressures, but others reported significant effects on the arterial side of the circulation, in particular on the so-called resistance vessels, manifested by afterload reduction and increase of cardiac output (5,6,7). These apparently contradictory results might be explained by the different nitrates used, by the different routes of administration, but most probably by the type of patients treated and their initial hemodynamics (8).