TY - JOUR
T1 - Lack of effect of nitrates on exercise stress test results in patients with microvascular angina
AU - Russo, Giulio
AU - Di Franco, Antonino
AU - Lamendola, Priscilla
AU - Tarzia, Pierpaolo
AU - Nerla, Roberto
AU - Stazi, Alessandra
AU - Villano, Angelo
AU - Sestito, Alfonso
AU - Lanza, Gaetano A.
AU - Crea, Filippo
PY - 2013/6
Y1 - 2013/6
N2 - 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
AB - 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
KW - Coronary microvascular dysfunction
KW - Exercise stress test
KW - Microvascular angina
KW - Nitrates
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U2 - 10.1007/s10557-013-6439-z
DO - 10.1007/s10557-013-6439-z
M3 - Article
C2 - 23338814
AN - SCOPUS:84887355863
VL - 27
SP - 229
EP - 234
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
SN - 0920-3206
IS - 3
ER -