Lack of effect of nitrates on exercise stress test results in patients with microvascular angina

Giulio Russo, Antonino Di Franco, Priscilla Lamendola, Pierpaolo Tarzia, Roberto Nerla, Alessandra Stazi, Angelo Villano, Alfonso Sestito, Gaetano A. Lanza, Filippo Crea

Research output: Contribution to journalArticlepeer-review

Abstract

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

Original languageEnglish
Pages (from-to)229-234
Number of pages6
JournalCardiovascular Drugs and Therapy
Volume27
Issue number3
DOIs
Publication statusPublished - Jun 2013

Keywords

  • Coronary microvascular dysfunction
  • Exercise stress test
  • Microvascular angina
  • Nitrates

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Cardiology and Cardiovascular Medicine
  • Pharmacology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Lack of effect of nitrates on exercise stress test results in patients with microvascular angina'. Together they form a unique fingerprint.

Cite this