RESULTS OF A ONE YEAR STUDY OF THE STABILITY OF INTRAVENOUS NITROGLYCERIN IN 5% GLUTATHIONE FOR TREATING ADHF AND RIGHT HEART FAILURE POST LVAD IMPLANTATION

BACKGROUND : Superoxide resulting from GTN tolerance causes diuretic resistance which limits the treatment of ADHF and right heart failure post LVAD implantation. Formulating IV GTN in 5% GSH is expected to benefit both these conditions with GTN targeting heart failure and GSH preventing diuretic resistance. The purpose of this study is to evaluate the stability of a new formulation of intravenous nitroglycerin (GTN) for use in treating ADHF and right heart failure post LVAD implantation. METHODS : a new protocol for formulating IV GTN in 5% GSH that is buffered with 2% L-arginine was used to create two solutions of GTN in 5% GSH. Following this the pH of two solutions of .2 mg/cc GTN in 5% GSH prepared according to the new protocol was tested. The solutions were then stored at room temperature for one year and observed for evidence of GSH oxidation. After one year, the pH of the solutions was retested. RESULTS: initial pH ranged 4.0 +/- .05 and was unchanged after one year. Both solutions remained clear without evidence of GSH oxidation after one year. CONCLUSION : this new formulation of IV GTN in 5% GSH is stable for use in treating ADHF and right heart failure post LVAD implantation for periods of up to one year. This new formulation has the potential to reduce the need for right ventricular assist devices following LVAD implantation and facilitate the explantation of LVADs thereby reducing the need for heart transplants.