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Erythrityl tetranitrate: sustained effects on systolic time intervals. Changes consistent with sustained preload reduction

The effects of sustained preload reduction have been demonstrated for several nitrates but not for erythrityl tetranitrate. In seven patients with coronary heart disease, a randomized double-blind crossover clinical trial showed that chewable erythrityl tetranitrate, 10 mg, produced significant changes in systolic time intervals consistent with preload reduction and lasting for at least four hours. As compared with placebo, ejection time index (ETI) fell and remained significantly low between 6 and 90 minutes after administration, and pre-ejection period (PEP), isovolumic contraction time (IVCT), and pre-ejection period/left ventricular ejection time (PEP/LVET) rose and remained significantly increased between 22 minutes and the four-hour endpoint. We conclude that erythrityl tetranitrate is a physiologically effective long-acting agent in patients with coronary heart disease.