Document Detail

Usefulness of changes in exercise tolerance induced by nitroglycerin in identifying patients with syndrome X.
MedLine Citation:
PMID:  8122598     Owner:  NLM     Status:  MEDLINE    
Two exercise tests, one under basal conditions and one after sublingual nitroglycerin (NTG), were performed in 39 patients with stable angina pectoris--16 with critical coronary stenoses and 23 with normal coronary arteries (syndrome X). Under basal conditions, times at ischemic threshold, at peak exercise, and at complete ECG recovery were similar in the two groups. Peak ST depression was significantly higher in patients with coronary artery disease (CAD). In a similar proportion of patients, ST-segment depression developed earlier or at a low heart rate. Patterns of heart rate, blood pressure, and rate-pressure product during exercise and recovery were also similar. After NTG an increase in the ischemic threshold was observed in a significantly higher proportion of patients with CAD (93.8% vs 39.1%). Furthermore, a subgroup of patients with syndrome X showed a worsening of exercise performance. This suggests that NTG does not directly affect small coronary vessels. Our results confirm that no relevant differences exist in exercise responses between patients with CAD and those with syndrome X under basal conditions. NTG-induced changes in this response could be useful in identifying patients with normal coronary arteries. Moreover, this test could be used as a guide to therapeutic approaches.
M Radice; V Giudici; A Albertini; A Mannarini
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  127     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-04-05     Completed Date:  1994-04-05     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  531-5     Citation Subset:  AIM; IM    
Metodologia Clinica, Universitá di Milano, Italy.
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MeSH Terms
Administration, Sublingual
Coronary Disease / diagnosis
Diagnosis, Differential
Exercise Tolerance / drug effects*
Microvascular Angina / diagnosis*
Middle Aged
Nitroglycerin / administration & dosage,  diagnostic use*,  pharmacology
Reg. No./Substance:

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