Randomized, Double-Blind, Placebo-Controlled Study of Ascorbate on the Preventive Effect of Nitrate Tolerance in Patients With Congestive Heart Failure

• DOI: 10.1161/01.cir.97.9.886
• Publication Date: 2012-06-12T00:41:02Z
• Authors: Hideki Watanabe; Masaaki Kakihana; Sadanori Ohtsuka; Yasuro Sugishita
• Keywords: Pulmonary wedge pressure

Reduced cGMP production caused by increased superoxide has been proposed as a mechanism of nitrate tolerance during continuous therapy. This study was designed to evaluate the effects ascorbate, an antioxidant, on development therapy in patients with congestive heart failure.Twenty failure were randomized receive intravenous infusion nitroglycerin concomitantly placebo (placebo group, n=10) or ascorbate (vitamin C n=10). After baseline measurements obtained, dose titration started at rate 0.5 microg/kg per minute (titration period). Measurements hemodynamic parameters and blood sampling performed serially 0, 6, 12, 18, 24 hours after period. At baseline, mean pulmonary artery pressure (MPAP, mm Hg), capillary wedge (PCWP, plasma vitamin E level (micromol/L), platelet (pmol/10[9] platelets) comparable two groups group: MPAP, 48+/-6; PCWP, 24+/-4; cGMP, 0.76+/-0.12; E, 18.2+/-1.2; C: 49+/-7; 0.71+/-0.16; 18.6+/-1.3). In both groups, 6 period, MPAP PCWP significantly decreased 26+/-5; 15+/-4; 26+/-4; 16+/-4), 2.42+/-0.24; 2.26+/-0.26). However, 18 titration, (44+/-5) (23+/-4) increased, (0.85+/-0.20) levels (12.4+/-1.4) decreased. contrast, (31+/-6), (17+/-5), (2.49+/-0.23), (17.6+/-1.4) maintained for period.These findings indicate that may prevent failure.