[Chronic aortic and mitral valve regurgitation. Effects of isosorbide dinitrate on systolic function and passive elastic properties of the left ventricle (author's transl)].

A haemodynamic and cineangiographic study was conducted in 20 patients with chronic aortic regurgitation alone or associated with mitral regurgitation before and during i.v. administration of isosorbide dinitrate 5 mg/hour. Freedom from coronary disease had been ascertained. The heart rate and aortic pressure (initially normal), cardiac index (initially low), pulmonary pressures and pulmonary and systemic resistances (slightly raised initially) remained unchanged. On the other hand, the left ventricular (LV) filling pressure, distinctly raised before treatment, was reduced by 17% (p less than 0.05). There was also a 10% reduction in LV end-diastolic volume (from 204 +/- 60- cm3.m2 to 184 +/- 56 cm3,m2; p less than 0.001) and a 14% reduction in LV end-systolic volume (from 104 +/- 39 cm3.m2 to 89 +/- 40 cm3.m3; p less than 0.001). LV geometry, stroke volume and regurgitation volume were unmodified. There was a significant improvement in ventricular function indices, globally reduced before treatment: + 8% for the fiber shortening amplitude (p less than 0.025), + 6% for the ejection fraction (p fiber shortening (p less than 0.01), and + 15% for the ESP: ESV ratio (p less than 0.05). The passive elasticity indices, all increased before treatment, also improved. It is concluded that isosorbide dinitrate improves LV systolic and diastolic functions in patients with chronic valve disease.