| Sustained reduction of exercise perfusion defect extent and severity with isosorbide mononitrate (Imdur) as demonstrated by means of technetium 99m sestamibi. | |
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MedLine Citation:
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PMID: 10958276 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The impact of long-acting nitrates on the extent and severity of stress-induced myocardial ischemia is not well described, especially after long-term treatment. METHODS: Forty patients with chronic stable angina and reversible ischemia on an exercise stress myocardial perfusion single photon emission computed tomography (ex-SPECT) were prospectively studied in a 6-week period. At baseline, rest thallium-201/exercise stress technetium 99m sestamibi SPECT was performed, followed by treatment with extended-release isosorbide 5-mononitrate (5-ISMN, Imdur). Follow-up ex-SPECT was performed 5 days and 6 weeks after the initiation of therapy with extended-release 5-ISMN. The exercise treadmill testing (ETT) protocol and exercise duration of the follow-up studies were the same as that of the baseline ETT. Defect extent and severity were analyzed both by means of an automated quantitative method, with CEqual software, and visually, with a 20-segment scoring system (which was also used to derive a summed stress score [SSS]). RESULTS: In the 6-week study period, significant reductions occurred in both the extent and the severity of exercise-induced ischemia by means of quantitative SPECT (13.8% [P<.0003] and 12.7% [P<.0003], respectively). There was no significant change in these variables between stages 2 (day 5) and 3 (6 weeks), indicating no development of tolerance to the nitrate effect. Similar reductions were noted by means of the visual analysis (SSS reduction of 13.0% [P<.002]) in the entire study period. CONCLUSIONS: Patients with chronic-stable-angina treated with a long-acting nitrate demonstrate improvement in myocardial perfusion defect extent and severity in an extended period by means of both visual and quantitative analysis of sequential exercise testing to the same rate-pressure product end point. |
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Authors:
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H C Lewin; R Hachamovitch; A G Harris; C Williams; J Schmidt; M Harris; K Van Train; G Siligan; D S Berman |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: 7 ISSN: 1071-3581 ISO Abbreviation: J Nucl Cardiol Publication Date: 2000 Jul-Aug |
Date Detail:
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Created Date: 2000-12-04 Completed Date: 2000-12-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 342-53 Citation Subset: IM |
Affiliation:
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Department of Imaging, Cedars-Sinai Medical Center, The CSMC Burns and Allen Research Institute, University of California Los Angeles, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / drug therapy, radionuclide imaging* Coronary Circulation Delayed-Action Preparations Exercise Test* Female Humans Isosorbide Dinitrate / analogs & derivatives*, therapeutic use* Male Prospective Studies Radiopharmaceuticals / diagnostic use* Technetium Tc 99m Sestamibi / diagnostic use* Thallium Radioisotopes / diagnostic use Tomography, Emission-Computed, Single-Photon* Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Delayed-Action Preparations; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi; 16051-77-7/isosorbide-5-mononitrate; 87-33-2/Isosorbide Dinitrate |
| Comments/Corrections | |
Comment In:
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J Nucl Cardiol. 2000 Jul-Aug;7(4):392-4
[PMID:
10958283
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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