Historical Vignettes in Heart Failure

Abstract

Congestive Heart FailureVolume 14, Issue 1 p. 54-54 Free Access Historical Vignettes in Heart Failure First published: 06 May 2008 https://doi.org/10.1111/j.1751-7133.2008.07774.xCitations: 1AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat History of Heart Failure “. . . the clinical and physiologic data obtained after nitroglycerin administration suggest that this drug has an important place in the management of patients with pulmonary-artery hypertension and paroxysmal dyspnea associated with failure of the left ventricle.”1 Commentary In 1867, the British pharmacologist Lauder Brunton discovered that amyl nitrite administered during an attack of angina pectoris could abort the paroxysm or at least reduce its severity. William Murrell of London extended Brunton's studies on nitrates and reported the value of nitroglycerin in the treatment of angina in 1879. Then, as now, enthusiasm for advances in therapeutics overshadowed the response to reports of new insights into the pathophysiology of disease processes. Some observers, however, recognized the critical role of basic research in the discovery of these “breakthroughs.” Referring to Brunton's discovery of the efficacy of amyl nitrite in angina, a reviewer exclaimed in 1883, “In few maladies are the improvements in our therapeutical resources more conspicuous. In the use of the most effective remedy for the relief of the paroxysm, an admirable illustration is given of the remarkable value of the contributions made to therapeutics by physiologic investigations.” Nitroglycerin was synthesized as a result of a systematic search for other explosives after Schonbein's discovery of “gun cotton,” a powerful explosive formed by the action of nitric acid on cotton. The Italian chemist Ascanio Sobrero first synthesized nitroglycerin in 1846 by combining nitric and sulfuric acids with glycerin. Nitroglycerin's possible value as a therapeutic agent was first investigated by Constantin Hering, a homeopathic physician. In 1957, Johnson and colleagues1 demonstrated that the symptomatic relief obtained by the use of nitroglycerin in patients with paroxysmal dyspnea and acute pulmonary edema was related to a rapid decrease in pulmonary artery and pulmonary capillary wedge pressures. Reference 1 Johnson JB, Gross JF, Hale E. Effects of sublingual administration of nitroglycerin on pulmonary artery pressure in patients with failure of the left ventricle. N Engl J Med. 1957; 251: 1114– 1117. Citing Literature Volume14, Issue1January/February 2008Pages 54-54 ReferencesRelatedInformation