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Nitrate and Hypertension in Heart Transplanted Patients

Information source: University of Zurich
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Hypertension; Heart Transplantation

Intervention: acute infusion of nitroglycerine into the pulmonary artery (Drug)

Phase: Phase 4

Status: Completed

Sponsored by: University of Zurich

Official(s) and/or principal investigator(s):
Roberto Corti, MD, Principal Investigator, Affiliation: Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland


The aim of the study was to evaluate the acute effect of nitroglycerine infusion on blood pressure and heart rate in heart-transplanted patients with cyclosporine-induced hypertension.

Clinical Details

Official title: Acute Effect of Nitroglycerin on Cyclosporine-Induced Hypertension After Cardiac Transplantation

Study design: Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Blood pressure reduction after acute nitroglycerine infusion

Secondary outcome: Heart rate modification after acute nitroglycerine infusion

Detailed description: Background: Cyclosporine represents a milestone in immunosuppression after organ transplantation. Its use, however, comes at the cost of significant side effects, such as arterial hypertension. Our aim was to investigate the effect of acute administration of nitroglycerin in heart-transplanted patients with cyclosporine-induced hypertension. Methods: We included 18 hypertensive patients (HT) scheduled for elective cardiac catheterization after heart transplantation and treated with cyclosporine, as well as 6-matched HT. Simultaneous measurements of BP in the aorta and pulmonary artery before and after administration of nitroglycerin were done. Results: After injection of 50μg and 100μg nitroglycerin a significant BP decrease was observed both in heart-transplanted patients (sBP p=0. 0001; dBP p=0. 0001) and in controls (sBP p=0. 006; dBP p=0. 05). This reduction was more pronounced in heart-transplanted patients (sBP p=0. 022; dBP 0. 018 for group comparison). 8±3 minutes after the last nitrate infusion BP remained significantly reduced vs baseline in heart-transplanted patients (p<0. 001) while it comes back to baseline in controls. The reduction in sBP (p=0. 04 after 50μg nitroglycerin; p=0. 05 after 100μg nitroglycerin) but not dBP correlated to cyclosporinemia. Conclusions: This study indicates that nitroglycerin reduces sBP in heart-transplanted patients with cyclosporine-induced hypertension. Further studies are needed to evaluate the long-term effect of nitrates in these patients.


Minimum age: 18 Years. Maximum age: 80 Years. Gender(s): Both.


Inclusion Criteria:

- Heart-transplanted group:

- Patients with hypertension and treated with cyclosporine

- Patients under optimal standard therapy

- Patients giving written informed consent

Control group:

- Patients with hypertension

- Patients without prior transplantation of any kind

- Patients giving written informed consent

Exclusion criteria:

- Hypertensive patients receiving immunosuppressive drugs

- Patients receiving any kind or nitrate derivates

Locations and Contacts

University Hospital of Zurich, Zurich CH8091, Switzerland
Additional Information

Starting date: January 2003
Last updated: March 15, 2007

Page last updated: August 23, 2015

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