TITLE

HEMODYNAMIC CHANGES ASSOCIATED WITH ANGINA PECTORIS INDUCED BY MAXIMAL TREADMILL EXERCISE: EFFECT OF SUBLINGUAL ISOSORBIDE DINITRATE ON SYSTOLIC TIME INTERVALS

AUTHOR(S)
Thompson, Eugene J.; Glass, Paul; Ansari, Abdul; Arora, Jodh
PUB. DATE
May 1976
SOURCE
Angiology;May1976, Vol. 27 Issue 5, p269
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
A technique for the study of patients with angina pectoris has been described, in which systolic time interval (STI) measurements are obtained at intervals after the onset of stress-induced angina. The technique is uniquely suited to the evaluation of anti-anginal drugs. Sublingual isosorbide dinitrate (SISD) was randomly alternated with a placebo (P) tablet in a double-blind study of 20 patients with stable angina pectoris. After SISD, compared to placebo, a highly significant shortening of Q-S2 and LVET occurred (p < 0.001) which lasted throughout the entire 120 minute study period. The hemodynamic basis for these differences was felt to be improved myocardial contractility secondary to a reduction in systemic vascular resistance and reduced venous return induced by the SISD. A significant prolongation of PEP occurred at 60 minutes post-SISD (p < 0.01). This was attributed to an increase in the gradient between LVEDP and aortic distolic pressure resulting from reduced venous return after SISD. The PEP/LVET ratio was significantly increased up to 60 minutes after SISD (P < 0.05). Heart rate was uniformly higher post-SISD, compared to post-placebo values; the differences were highly significant up to 60 minutes (P < 0.001) and remained significant at 120 minutes (p < 0.05). The time to angina was significantly longer (immediately post SISD. p < 0.05; 30 min, p < 0.001; 60 mins, p < 0.05; 120 mins, p < 0.05); and the work load greater, for 120 minutes following SISD: the increase in the latter was highly significant for 30 minutes after SISD (p < 0.001) and remained significant up to 120 minutes (60 mins, p < 0.05; 120 mins, p < 0.05). These observations were attributed to an improvement in myocarcial function due to the sublingual isosorbide dinitrate. A high degree of correlation was found to exist between heart rate and the STI. This correlation was negative for the QS2 interval (-0.996) and LVET (-0.993) and positive for PEP (+0.817) and the PEP/LVET ratio (+0.950).
ACCESSION #
16353301

 

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