| Lack of Effect of Nitrates on Exercise Stress Test Results in Patients with Microvascular Angina. | |
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MedLine Citation:
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PMID: 23338814 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: To assess the effects of short-acting nitrates on exercise stress test (EST) results and the relation between EST results and coronary blood flow (CBF) response to nitrates in patients with microvascular angina (MVA). METHODS: We completed 2 symptom/sign limited ESTs on 2 separate days, in a random sequence and in pharmacological washout, in 29 MVA patients and in 24 patients with obstructive coronary artery disease (CAD): one EST was performed without any intervention (control EST, C-EST), and the other after sublingual isosorbide dinitrate, 5 mg (nitrate EST, N-EST). CBF response to nitroglycerin (25 μg) was assessed in the left anterior descending coronary artery by transthoracic Doppler-echocardiography. RESULTS: At C-EST. ST-segment depression ≥1 mm (STD) was induced in 26 (90 %) and 23 (96 %) MVA and CAD patients, respectively (p = 0.42), whereas at N-EST, STD was induced in 25 (86 %) and 14 (56 %) MVA and CAD patients, respectively (p = 0.01). Time and rate pressure product at 1 mm STD increased during N-EST, compared to C-EST, in CAD patients (475 ± 115 vs. 365 ± 146 s, p < 0.001; and 23511 ± 4352 vs. 20583 ± 6234 bpm[Symbol: see text]mmHg, respectively, p = 0.01), but not in MVA patients (308 ± 160 vs. 284 ± 136 s; p = 0.19; and 21290 ± 5438 vs. 20818 ± 4286 bpm[Symbol: see text]mmHg, respectively, p = 0.35). In MVA patients, a significant correlation was found between heart rate at STD during N-EST and CBF response to nitroglycerin (r = 0.40, p = 0.04). CONCLUSIONS: Short-acting nitrates improve EST results in CAD, but not in MVA patients. In MVA patients a lower nitrate-dependent coronary microvascular dilation may contribute to the lack of effects of nitrates on EST results. |
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Authors:
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Giulio Russo; Antonino Di Franco; Priscilla Lamendola; Pierpaolo Tarzia; Roberto Nerla; Alessandra Stazi; Angelo Villano; Alfonso Sestito; Gaetano A Lanza; Filippo Crea |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-22 |
Journal Detail:
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Title: Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy Volume: - ISSN: 1573-7241 ISO Abbreviation: Cardiovasc Drugs Ther Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8712220 Medline TA: Cardiovasc Drugs Ther Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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