Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine

M. D. Winniford, P. L. Kennedy, P. J. Wells, L. D. Hillis

Research output: Contribution to journalArticle

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Abstract

Previous studies have suggested that (1) nitroglycerin causes vasodilatation by interacting with sulfhydryl groups in vascular smooth muscle, thereby activating guanylate cyclase and increasing the intracellular concentration of cyclic GMP, and (2) N-acetylcysteine, a source of sulfhydryl groups, potentiates the peripheral vasodilatory effect of nitroglycerin. This study was performed to explore the influence of N-acetylcysteine on nitroglycerin-induced coronary dilatation. In 18 patients (13 men and five women, 30 to 76 years old), coronary sinus blood flow (by thermodilution) was measured before and during intracoronary administration of nitroglycerin, 25 μg, both before and 5 min after a 15 min intravenous infusion of (1) 5% dextrose in water (n = 8, control) or (2) 100 mg/kg N-acetylcysteine (n = 10). Nitroglycerin caused no change in heart rate or systemic arterial pressure. In the control patients, coronary sinus blood flow behaved similarly during the two injections: it was 134 ± 36 ml/min (mean ± SD) before and 183 ± 50 ml/min during injection No. 1 (average increase, 49 ± 25 ml/min; average percent increase, 38 ± 21%); and it was 131 ± 34 ml/min before and 178 ± 45 ml/min during injection No. 2 (average increase, 47 ± 23 ml/min; average percent increase, 37 ± 20%) (NS compared with injection 1). In the patients who received N-acetylcysteine, coronary sinus blood flow was 149 ± 48 ml/min before and 191 ± 54 ml/min during injection 1 (average increase, 42 ± 15 ml/min; average percent increase, 30 ± 12%) (NS compared with eight control values). After N-acetylcysteine, coronary sinus blood flow was similar before nitroglycerin (145 ± 44 ml/min, but it rose markedly with nitroglycerin (218 ± 68 ml/min) (average increase, 73 ± 35 ml/min; average percent increase, 50 ± 20%) (p<.01 compared with the values obtained in the same patients during injection 1). Thus, N-acetylcysteine, a source of sulfhydryl groups, potentiates the coronary vasodilative effect of nitroglycerin.

Original languageEnglish (US)
Pages (from-to)138-142
Number of pages5
JournalCirculation
Volume73
Issue number1
StatePublished - 1986
Externally publishedYes

Fingerprint

Nitroglycerin
Acetylcysteine
Dilatation
Coronary Sinus
Injections
Thermodilution
Guanylate Cyclase
Cyclic GMP
Vascular Smooth Muscle
Intravenous Infusions
Vasodilation
Arterial Pressure
Heart Rate
Glucose
Water

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Winniford, M. D., Kennedy, P. L., Wells, P. J., & Hillis, L. D. (1986). Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine. Circulation, 73(1), 138-142.

Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine. / Winniford, M. D.; Kennedy, P. L.; Wells, P. J.; Hillis, L. D.

In: Circulation, Vol. 73, No. 1, 1986, p. 138-142.

Research output: Contribution to journalArticle

Winniford, MD, Kennedy, PL, Wells, PJ & Hillis, LD 1986, 'Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine', Circulation, vol. 73, no. 1, pp. 138-142.
Winniford MD, Kennedy PL, Wells PJ, Hillis LD. Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine. Circulation. 1986;73(1):138-142.
Winniford, M. D. ; Kennedy, P. L. ; Wells, P. J. ; Hillis, L. D. / Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine. In: Circulation. 1986 ; Vol. 73, No. 1. pp. 138-142.
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abstract = "Previous studies have suggested that (1) nitroglycerin causes vasodilatation by interacting with sulfhydryl groups in vascular smooth muscle, thereby activating guanylate cyclase and increasing the intracellular concentration of cyclic GMP, and (2) N-acetylcysteine, a source of sulfhydryl groups, potentiates the peripheral vasodilatory effect of nitroglycerin. This study was performed to explore the influence of N-acetylcysteine on nitroglycerin-induced coronary dilatation. In 18 patients (13 men and five women, 30 to 76 years old), coronary sinus blood flow (by thermodilution) was measured before and during intracoronary administration of nitroglycerin, 25 μg, both before and 5 min after a 15 min intravenous infusion of (1) 5{\%} dextrose in water (n = 8, control) or (2) 100 mg/kg N-acetylcysteine (n = 10). Nitroglycerin caused no change in heart rate or systemic arterial pressure. In the control patients, coronary sinus blood flow behaved similarly during the two injections: it was 134 ± 36 ml/min (mean ± SD) before and 183 ± 50 ml/min during injection No. 1 (average increase, 49 ± 25 ml/min; average percent increase, 38 ± 21{\%}); and it was 131 ± 34 ml/min before and 178 ± 45 ml/min during injection No. 2 (average increase, 47 ± 23 ml/min; average percent increase, 37 ± 20{\%}) (NS compared with injection 1). In the patients who received N-acetylcysteine, coronary sinus blood flow was 149 ± 48 ml/min before and 191 ± 54 ml/min during injection 1 (average increase, 42 ± 15 ml/min; average percent increase, 30 ± 12{\%}) (NS compared with eight control values). After N-acetylcysteine, coronary sinus blood flow was similar before nitroglycerin (145 ± 44 ml/min, but it rose markedly with nitroglycerin (218 ± 68 ml/min) (average increase, 73 ± 35 ml/min; average percent increase, 50 ± 20{\%}) (p<.01 compared with the values obtained in the same patients during injection 1). Thus, N-acetylcysteine, a source of sulfhydryl groups, potentiates the coronary vasodilative effect of nitroglycerin.",
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