Effects Of Nitroglycerin Research Articles

Abstract WP349: Feeding Status After Stroke and Effect of Glyceryl Trinitrate: Data From the Efficacy of Nitric Oxide in Stroke (ENOS) Trial

Background: Post-stroke dysphagia is common, associated with poor outcome, and patients often require non-oral feeding/fluids. The relationship of feeding status on outcome, and treatment with transdermal glyceryl trinitrate (GTN) was studied in the ENOS trial. Methods: ENOS assessed GTN (5 mg vs none for 7 days) in 4,011 patients with acute stroke and high blood pressure. Feeding status (oral = normal diet, soft diet; non-oral = nasogastric tube, percutaneous endoscopic gastrostomy tube, parenteral fluids, none) was assessed at baseline and day 7. The primary outcome was the modified Rankin Scale (mRS) measured at day 90. Analyses of outcomes were adjusted for baseline covariates. †2p<0.001. Results: In comparison with oral feeding, non-oral patients (N=1331, 33.2%) were older (73.9 vs 68.5 years†), more likely to be female (47.3 v 40.4%†) and had more severe stroke (Scandinavian Stroke Scale 24.6 v 38.3†). By day 7, 56.8% patients had improved from non-oral to oral feeding, and 4.4% had deteriorated. Non-oral feeding at baseline was associated with more impairment at day 7 (SSS 29.0 v 43.7†), and higher mRS 4.0 (1.7) v 2.7 (1.6)†) and death (23.6% v 6.8%†) at day 90. Although GTN did not modify feeding status overall, randomisation to GTN <6 hours of stroke was associated with a significant shift to improved feeding status at day 7 (OR=0.61, 95% CI 0.38-0.98). Conclusions: Non-oral feeding status is common in acute stroke and associated with more impairment, dependency and death. Very early administration of GTN improved feeding status, a finding that requires further testing.

Effect of Treatment Delay, Stroke Type, and Thrombolysis on the Effect of Glyceryl Trinitrate, a Nitric Oxide Donor, on Outcome after Acute Stroke: A Systematic Review and Meta-Analysis of Individual Patient from Randomised Trials.

Background. Nitric oxide (NO) donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using individual patient data (IPD) from completed trials. Methods. Randomised controlled trials of NO donors in patients with acute or subacute stroke were identified and IPD sought from the trialists. The effect of NO donor versus control on functional outcome was assessed using the modified Rankin scale (mRS) and death, by time to randomisation. Secondary outcomes included measures of disability, mood, and quality of life. Results. Five trials (4,197 participants) were identified, all involving glyceryl trinitrate (GTN). Compared with control, GTN lowered blood pressure by 7.4/3.3 mmHg. At day 90, GTN did not alter any clinical measures. However, in 312 patients randomised within 6 hours of stroke onset, GTN was associated with beneficial shifts in the mRS (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.34–0.78) and reduced death (OR 0.32, 95% CI 0.14–0.78). Conclusions. NO donors do not alter outcome in patients with recent stroke. However, when administered within 6 hours, NO donors might improve outcomes in both ischaemic and haemorrhagic stroke.

Effect of botulinum toxin A and nitroglycerin on random skin flap survival in rats.

A suitable pharmacological substitute for the well-established surgical delay technique for random skin flaps to increase viability has been elusive. To evaluate the effects of nitroglycerin and botulinum toxin type A on random flap survival in a rat model. The present controlled experimental study was performed in the four groups of rats. One week after intervention in each group, the flap was raised and kept in situ, and flap necrosis was evaluated through follow-up. Group 1 received intradermal botulinum toxin type A (BTX-A) and topical nitroglycerin 2%; group 2 received BTX-A and topical Vaseline (Unilever, USA); group 3 received topical nitroglycerin and intradermal normal saline; and group 4 received topical Vaseline and intradermal normal saline. BTX-A reduced the area of necrosis compared with control (24% versus 56% respectively; P<0.001). Nitroglycerin application was associated with a trend toward improved flap viability (42% versus 56%; P=0.059). The combination of topical nitroglycerin and BTX-A, compared with Vaseline and BTX-A, was associated with decreased flap necrosis (16.1% versus 24%, respectively), although it was not statistically significant (P=0.45). BTX-A was effective in reducing distal flap necrosis. The effect of BTX-A was significantly more pronounced than nitroglycerin ointment.

Evaluation of analgesic effect of nitroglycerine added to lignocaine in intravenous regional anesthesia

Background: In this study, we used nitroglycerine (NTG) as an adjuvant to lignocaine in intravenous regional anesthesia (IVRA) to enhance the analgesic property of lignocaine. Aim: To evaluate the effect of addition of NTG to lignocaine in IVRA. Objective: To find out the onset, duration, and requirement of postoperative analgesics with the addition of NTG. Materials and Methods: This was a randomized (block randomization), double-blinded, placebo-controlled study of 60 patients of the American Society of Anesthesiologists Class I and II, undergoing hand and forearm surgeries. Patients received IVRA with 3 mg/kg 2% lignocaine diluted to a total volume of 40 ml to which either 150 μg NTG or equal volume of saline was added. Intraoperatively and postoperatively, pain score was evaluated using visual analog scale. The sensory and motor block onset and recovery time and the subsequent analgesic requirement in first 24 h were recorded. Results: Motor and sensory block onset time were significantly shorter (P < 0.001), and motor and sensory block recovery time were prolonged (P < 0.001) in NTG group compared to plain lignocaine group. Intra-operatively fentanyl requirement was significantly lower and quality of sensory and motor blockade was better in study group than control group (P < 0.001). In addition, patients in NTG group required significantly less number of analgesics in the first 24 h as compared to the other group. Nitrates are potent relaxers of vascular smooth muscles and act by dilating veins, arteries, and arterioles. In IVRA, most of the anesthetic agent is absorbed into the limb tissue. Thus, the local anesthetic agent reaches to the nerves and nerve endings quickly. Thus shortens the onset time and also prolongs sensory and motor blockade and reduces total analgesic consumption in first 24 h without significant side effects. Conclusion: NTG as an adjuvant to lignocaine for IVRA reduces the total analgesic consumption in first 24 h and improves sensory and motor block without side effects.

Transdermal Nitroglycerin Versus Oral Nifedipine for Suppression of Preterm Labor

Background:: One of the most serious complications of pregnancy is preterm labor (PTL) and delivery. Further, there are different tocolytic agents available to enhance the time of delivery. Objectives:: The aim of this study was to compare the effectiveness of transdermal nitroglycerin (glyceryl trinitrate, GTN) and oral nifedipine for managing preterm labor. Patients and Methods:: This was a randomized clinical trial involving women who were admitted to our hospital with a diagnosis of PTL. Group one received transdermal GTN, whereas group two received oral nifedipine. All vital signs, fetal heart rate (FHR), contractions, dilation, and effacement, as well as gestation age at the time of delivery, have been monitored and evaluated in both groups of patients. Our main goal was the postponement of delivery so as to secure the most beneficial effect of primary corticosteroid administration for the fetus. Results:: Both groups were matched regarding age, gestational age at the time of tocolytic therapy, height of fundus, history of pregnancy, abortion, delivery, and stillbirth, primary body temperature, and systolic and diastolic blood pressure. Those who received GTN had a more prolonged delay of delivery. Also, the GTN group had infants with better one- and five-minute Apgar scores. Although both groups reported minimal side effects, tachycardia and nausea were reported more frequently in GTN patients. Conclusions:: Transdermal GTN was shown to be more effective in controlling PTL compared to oral nifedipine in terms of both maternal and neonatal effects.

Post-procedural/pre-hemostasis intra-arterial nitroglycerin after transradial catheterization: A gender based analysis.

We analyzed the effect of nitroglycerin on radial artery occlusion (RAO) in women undergoing transradial catheterization. A total of 1706 patients undergoing transradial catheterization were randomized to receive either 500μg intra-arterial nitroglycerin or placebo at the end of the radial procedure. We explored the gender-based analysis between women (n=539) and men (n=1167). The primary outcome was the incidence of RAO as confirmed by absence of antegrade flow at one day after the transradial procedure evaluated by duplex ultrasound of the radial artery. The use of nitroglycerin, as compared with placebo, did not significantly reduce the risk of RAO in women patients [odds ratio, 0.69; 95% confidence interval (CI), 0.38 to 1.26; P=0.147]. The risk of RAO was higher in women age <60years as compared with women age ≥60years [5.6% vs. 3.5%; odds ratio, 2.16; 95% CI, 1.18 to 3.94; P=0.008]. In women age <60years (n=237), both counter puncture technique and a duration of hemostasis ≥4h were associated with a similar enhanced risk of developing RAO (odds ratio, 3.51; 95% CI, 1.59 to 7.72; P<0.001). The administration of nitroglycerin at the end of a transradial catheterization in women did not reduce the risk of RAO as determined by ultrasound one day after the radial procedure. Age <60years was associated with a higher risk of RAO compared with age ≥60years in women. Further strategies to reduce RAO in women are needed.

The effect of transdermal nitroglycerin on pain control in diabetic patients with peripheral neuropathy.

BackgroundDespite high prevalence of diabetic peripheral neuropathy there is no definite treatment for the condition. The present study was conducted to assess the efficacy of transdermal nitroglycerin patch in pain control of patients with DPN.MethodsThis randomized, double-blind, crossover study was conducted on 30 patients with symmetric distal peripheral neuropathy and good glycemic control. The patients were randomly assigned to receive nitroglycerin transdermal and placebo patches in two 4-week stages. The severity of pain and other neuropathic sensory symptoms were assessed at the end of each course.ResultsMean reduction of pain severity was more prominent in the NTG group compared to placebo group of the study (p = 0.048) at least during the first phase of the study. Except for mood and sleep, a significant reduction in all Brief Pain Inventory scores was noted in the drug group (all corrected p < 0.05). SF-MPQ also showed the drug patch to be effective in improving different aspects of pain measured using McGill Pain Questionnaire, except for Role–emotional.ConclusionsIt could be concluded that nitroglycerin plasters can effectively help alleviate pain in patients with diabetic neuropathy.Trial registrationIRCT201308223213N1

Lack of effect of nitroglycerin on the diameter response of larger retinal arterioles in normal persons during hypoxia.

Retinal hypoxia with consequent changes in blood flow play a role in a number of vision-threatening diseases, such as diabetic retinopathy. Previous studies have shown that the inhibition of nitric oxide synthase (NOS) and cyclooxygenase (COX) products are involved in the diameter regulation of the retinal vessels during hypoxia. Therefore, the aim of the present study was to examine the effects of an NO donor combined with COX inhibition on the diameter regulation of retinal vessels during hypoxia in normal persons. Twenty normal persons aged 21-47years were examined. The Dynamic Vessel Analyzer (DVA) was used to measure retinal vessel diameters at rest, during isometric exercise, and during flicker stimulation. The measurements were performed during normoxia and hypoxia before and after sublingual administration of the NO donor nitroglycerin, and were repeated on a second study day after topical administration of the COX-inhibitor diclofenac. The resting diameter of arterioles and venules increased significantly during hypoxia (p < 0.0001). Hypoxia also significantly reduced the arteriolar constriction during isometric exercise, and the dilatation of the arterioles and venules during flicker stimulation (p < 0.0001). Diclofenac further reduced the arteriolar constriction induced by isometric exercise during hypoxia (p = 0.005). However, the NO-donor nitroglycerin had no effect on vascular diameters. Diameter regulation of retinal vessels during hypoxia in normal persons can be influenced by the inhibition of COX products, but not by increasing the NO concentration. The findings suggest that the vasoactive effects of NO on retinal arterioles during hypoxia are saturated in normal persons.

GW26-e2353 The Immediate Effect of ATP and Nitroglycerin on Coronary Slow-flow Angina Pectoris

To study the immediate effect of injecting ATP and nitroglycerin into coronary artery on treating Coronary Slow Flow Angina(CSFA). 56 patients, complaining the Angina symptom, without stenotic lesions of epicardial major arteries and with slow flow in anterior descending branch (LAD), both of which

The effects of nitroglycerine and COX‐inhibition on retinal vessel diameters during hypoxia

PurposeRetinal hypoxia plays a role in the pathophysiology of retinal vascular diseases such as diabetic retinopathy. Previous studies have shown that nitric oxide (NO) and cyclooxygenase (COX) products are involved in hypoxia‐induced dilatation of the retinal vessels. Therefore, the purpose of this study was to examine the effect of an NO donor and inhibition of COX products on the diameter regulation of retinal vessels during hypoxia in healthy subjects.MethodsTwenty normal persons were examined with the Dynamic Vessel Analyzer (DVA). Retinal vessel diameters were measured at rest, and during isometric exercise and flicker stimulation. The measurements were performed during normoxia and hypoxia before and after sublingual administration of the NO donor nitroglycerine, and were repeated on a second study day after topical administration of the COX‐inhibitor diclofenac.ResultsHypoxia alone and combined with nitroglycerine significantly reduced both arteriolar constriction during isometric exercise and dilatation during flicker stimulation (p &lt; 0.0001). Diclofenac further reduced the arteriolar constriction induced by isometric exercise during hypoxia (p = 0.005). Nitroglycerine alone had no effect on the retinal vessel diameters.ConclusionsDiameter regulation of retinal vessels during hypoxia in normal persons is affected by inhibition of COX products but not by increased NO. The results contribute to understanding of retinal flow regulation and thereby to the identification of possible new strategies for intervention on diseases characterized by disturbances in retinal blood flow.

OC15.06: Study of nitric oxide level in pre‐eclampsia and the effect of nitroglycerine on Doppler changes in fetal and maternal vessels

OC15.06: Study of nitric oxide level in pre‐eclampsia and the effect of nitroglycerine on Doppler changes in fetal and maternal vessels

The Usefulness of 0.2% Topical Nitroglycerin for Chondrodermatitis Nodularis Helicis

Background and objectiveChondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. Material and methodsWe performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. ResultsOf the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. ConclusionTopical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH.

The Effects of Nitroglycerine on Pain Control During the Propofol Injection; a Controlled, Double-Blinded, Randomized Clinical Trial.

Background:The use of Propofol often results in pain upon injection, which is sometimes very distressing for patients. Many patients report some degree of pain or discomfort on injection with propofol. Injection-induced pain during induction of anesthesia can result in patient's discomfort.Objectives:This study was performed to evaluate the effects of nitroglycerine on pain severity in patients undergoing propofol injection.Patients and Methods:In this double-blind randomized clinical trial, 100 patients with ASA class I and II undergoing anesthesia with propofol injection were selected for the study from 2012 to 2013 in Imam Reza training hospital. Patients were randomly assigned to case and control groups and received either 20 μg of nitroglycerine or normal saline as placebo. The severity of injection pain was assessed using a four-point scale. An anesthesiologist observed hemodynamic and local adverse effects.Results:The pain severity in nitroglycerine group was significantly lower compared with the placebo group (P < 0.0001). Moreover, the local adverse reactions were observed only in three patients in the placebo group while no patient in the drug group experienced adverse effects (P = 0.242). The systolic blood pressure showed no significant difference between two groups before and after the induction of anesthesia but the diastolic blood pressure and the heart rate was significantly different between study groups.Conclusions:Nitroglycerine may be a safe and effective adjuvant therapeutic for pain reduction in patients under propofol injection. Hence, its use for reduction of propofol injection-induced pain is recommended.

Analgesic Effects of Additional Nitroglycerine in Intravenous Regional Lidocaine-Based Anesthesia Through Forearm Surgery

Background: Intravenous regional anesthesia (IVRA) (or Bier’s block) is the administration of a local anesthetic drug to an organ intravenously, when compressed by tourniquet. Simple use in outpatient and emergency settings, being regional instead of general anesthesia and having reasonable costs make IVRA most acceptable. Objectives: Nitroglycerine, as a safe and available medication, was evaluated by the current study in the search for better analgesia withlower complications that plays the role of a suitable adjuvant in regional anesthesia by lidocaine. Patients and Methods: Through a randomized controlled clinical trial, two types of anesthesia were used regionally for 70 cases of forearm surgery between 2010 and 2011. Elective cases of forearm surgery with American Society of Anesthesiologist (ASA) class I or II were enrolled in the study and were randomly divided to two groups of cases and controls. For the control group, lidocaine was used alone for IVRA while for the intervention group lidocaine as well as 200 µg of nitroglycerin was used through the procedure. Results: On average, sensory block started in 3.48 and 6.5 minutes, for the case and control groups, respectively. The mean motor block time was 4.18 and 6.98 minutes for the cases and controls, respectively. The groups differed in terms of times required for sensory and motor blocks. Recovery time was longer among cases (118.32 ± 7.8 minutes) when compared to the controls. Conclusions: Nitroglycerin at a dose range between 200 and 400 µg, as an adjunct for lidocaine, can evidently improve regional anesthesia, increase block recovery time and postpone the need for postoperative analgesics, especially opioids.

Sublingual Nitroglycerin Administration in Coronary Computed Tomography Angiography: a Systematic Review.

ObjectiveTo systematically investigate the literature for the influence of sublingual nitroglycerin administration on coronary diameter, the number of evaluable segments, image quality, heart rate and blood pressure, and diagnostic accuracy of coronary computed tomography (CT) angiography.MethodsA systematic search was performed in PubMed, EMBASE and Web of Science. The studies were evaluated for the effect of sublingual nitroglycerin on coronary artery diameter, evaluable segments, objective and subjective image quality, systemic physiological effects and diagnostic accuracy. Due to the heterogeneous reporting of outcome measures, a narrative synthesis was applied.ResultsOf the 217 studies identified, nine met the inclusion criteria: seven reported on the effect of nitroglycerin on coronary artery diameter, six on evaluable segments, four on image quality, five on systemic physiological effects and two on diagnostic accuracy. Sublingual nitroglycerin administration resulted in an improved evaluation of more coronary segments, in particular, in smaller coronary branches, better image quality and improved diagnostic accuracy. Side effects were mild and were alleviated without medical intervention.ConclusionSublingual nitroglycerin improves the coronary diameter, the number of assessable segments, image quality and diagnostic accuracy of coronary CT angiography without major side effects or systemic physiological changes.Key Points• Sublingual nitroglycerin administration results in significant coronary artery dilatation.• Nitroglycerin increases the number of evaluable coronary branches.• Image quality is improved the most in smaller coronary branches.• Nitroglycerin increases the diagnostic accuracy of coronary CT angiography.• Most side effects are mild and do not require medical intervention.

La utilidad de la nitroglicerina tópica al 0,2% en la condrodermatitis nodular del hélix

Background and objectiveChondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. Material and methodsWe performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. ResultsOf the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. ConclusionTopical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH.

Intravenous Infusion of Nitroglycerine Leads to Increased Permeability on Dynamic Contrast-Enhanced MR Imaging in Pig Brains.

It has been suggested that off-label use of transdermal nitroglycerine patches to prevent frostbite may lead to severe acute mountain sickness and ataxia. The aim of this study was to investigate the effect of nitroglycerine on brain vascular permeability by using dynamic contrast-enhanced MR imaging in a swine model. Eight Danish Landrace-Yorkshire-Danish Landrace pigs of approximately 20-25 kg were scanned with a dynamic contrast-enhanced MR perfusion protocol with and without nitroglycerine intravenous infusion. Compartmental analysis was performed on the basis of the Tofts model, and voxel-based quantitative values of the volume transfer constants from the vascular to the extracellular space were determined. The scan with nitroglycerine infusion resulted in significantly higher volume transfer constant values than values derived from the first scan without nitroglycerine infusion. Increased volume transfer constant values were observed in 6 of 8 animals. Infusion of nitroglycerine increases the vascular permeability of the swine brain on the basis of the transfer constant estimated from dynamic contrast-enhanced MR imaging.

Positive effect of sublingual nitroglycerin on performance of non-contrast enhanced magnetic resonance coronary angiography

Background Cardiac magnetic resonance imaging (CMR) is increasingly proposed for non-invasive detection of relevant coronary artery disease (CAD), currently using an integrated assessment of myocardial perfusion, viability and function. Magnetic resonance coronary artery imaging (MRCA) is still experimental. Currently, it is not proven if sublingual nitroglycerin (slNitro) should be given to enhance performance of MRCA. Methods 15 volunteers, 9 (60%) of them male, mean age 37.2 years (±11) without known CAD underwent MRCA, without and with slNitro. slNitro dosage was adjusted according to blood pressure (systolic blood pressure (BP) >180 mmHg =>1.6 mg glyceroltrinitrat, BP 140-179 mmHg =>1.2 mg, BP 100-139 mmHg =>0.8 mg, BP 90-100mmHg =>0.4mg). All volunteers were examined in supine position using a GE Signa HDxt 1.5 Tesla scanner, equipped with EchoSpeed gradients, and a dedicated 8-element phased array cardiac coil (GE Healthcare, Milwaukee, Wisconsin). For imaging of the coronary arteries a commercially available whole heart 3D navigator gated multislab steady state free precession sequence (3D HEART, based on 3D FatSat FIESTA) without the administration of contrast medium was employed. This sequence is designed for free breathing cardiac MR angiography, using a navigator echo pulse that detects motion of the diaphragm. We used an abdominal belt in all vol to reduce motion of the diaphragm. Post processing was perfomed with cvi 42 5.0 (Circle, Calgary, Canada). Vessel diameter was measured before and after slNitro. Image quality was graded visually before and after slNitro on a 4-point scale: 1 = non-assessable with severe image artifacts, poor vessel contrast; 2 = assessable with

THE EFFECTS OF NITROGLYCERIN ON THE PROLIFERATIVE AND MIGRATORY POTENTIAL OF PERIPHERAL BLOOD MONONUCLEAR CELLS

Aim. To study the effects of nitroglycerin on proliferative and migratory activity of mononuclear cells and endothelial progenitor cells in patients with chronic heart failure. Materials and methods. Proliferative potential of peripheral blood mononuclear cells in donors and patients were studied in MTT-test in the presence of 50 and 100 mg/ml nitroglycerin. Proliferation and migration of endothelial progenitor cells in patients were evaluated by changes in the cell impedance in real-time in the presence of various doses of nitroglycerin. Results. It is shown that nitroglycerin reduces in vitro both spontaneous and Concanavalin A stimulated proliferative activity of mononuclear cells in patients with chronic heart failure. Peripheral blood mononuclear cells in patients with chronic heart failure, obtained after procedure of mobilization by granulocyte colony-stimulating factor respond to nitroglycerin dose of 50 mg/ml with the increased proliferative activity, and with the suppressed proliferative activity to nitroglycerin dose of 100 mg/ml. Mononuclear cells of healthy donors respond to 50 mg/ml of nitroglycerin with the activation of proliferative capacity, but at a dose of 100 mg/ml spontaneous proliferative activity of mononuclear cells inhibit. It is also shown that the presence of nitroglycerin in medium dose in stimulating test leads to the inhibition of mononuclear cells proliferation from healthy donors. It is shown the stimulating effect of nitroglycerin on proliferative and migration potential of endothelial progenitor cells. Conclusion. Multidirectional and dose-dependent effects of nitroglycerin to the various types of human cells in vitro were observed.

Effectiveness of glyceryl trinitrate (GTN) vasodilator patches in peripheral arterial disease

Background Foot ulceration is caused by a variety of factors including ischemia. GTN is a nitric oxide donor that reliably causes vasodilation, but its potential to improve local vascular supply to at-risk feet has received little attention. When used to supplement standard evidence-based wound care, transdermal GTN produced rapid ulcer healing in four cases of non diabetic and diabetic ulcers. Subsequently, a larger study was conducted to investigate the effect of using small doses of GTN for therapeutic neurological and vascula outcomes in people with subnormal toe pressures.