Document Detail


Effects of infusion of L-arginine on exercise-induced myocardial ischemic ST-segment changes and capacity to exercise of patients with stable angina pectoris.
MedLine Citation:
PMID:  10421972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Results of recent studies show that intracoronary administration of L-arginine, the precursor of nitric oxide, restores endothelial function in subjects with coronary risk factors and minimal coronary artery lesions. However, few investigators have examined the clinical feasibility of using L-arginine for treatment of myocardial ischemia due to coronary artery disease. OBJECTIVE: To examine the effect of supplementary L-arginine on exercise-induced myocardial ischemia and capacity to exercise of patients with stable effort angina pectoris. METHODS: Twelve patients confirmed to have a single epicardial coronary artery stenosis underwent two treadmill exercise tests after infusion of 10% L-arginine solution or placebo (5% dextrose) according to a randomized single-blind crossover design on two days separated by an interval of less than 1 week. Respiratory gas exchange kinetics were measured and myocardial ischemia was estimated by electrocardiography before and during exercise. RESULTS: Infusion of L-arginine did not alter exercise-induced changes in heart rate and blood pressure, and objective parameters of capacity to exercise. Exercise-induced maximum ST-segment depression (by 2.1 +/- 0.9 mm; with L-arginine; by 1.9 +/- 0.9 mm with placebo, NS) and onset of 1 mm ST-segment depression after exercise (after 261 +/- 131 s with L-arginine; after 247 +/- 136 s with placebo, NS) also remained unchanged. However, ST-segment depression was restored to baseline after exercise significantly more quickly after infusion of L-arginine than it did with placebo (after 331 +/- 167 s with L-arginine; after 400 +/- 165 s with placebo: P < 0.01). CONCLUSION: Intravenous administration of L-arginine did not alter capacity to exercise or the threshold for exercise-induced myocardial ischemia. However, it did reduce the time taken for recovery after ST-segment depression, suggesting that an earlier resolution of exercise-induced myocardial ischemia occurred.
Authors:
N Kobayashi; M Nakamura; K Hiramori
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Coronary artery disease     Volume:  10     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-09-20     Completed Date:  1999-09-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  321-6     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / drug therapy,  physiopathology*
Arginine / administration & dosage,  therapeutic use*
Electrocardiography
Exercise Test
Exercise Tolerance / drug effects*
Female
Humans
Infusions, Intravenous
Male
Myocardial Ischemia / physiopathology*
Nitric Oxide / physiology
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide; 74-79-3/Arginine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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