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Isosorbide dinitrate and cardiovascular adaptation to exercise.

L Hurwitz, J Naughton, P A Gorman

    Chest
    |January 1, 1976
    PubMed
    Summary
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    Chewable isosorbide dinitrate effectively reduced cardiovascular workload in angina pectoris patients. While it lowered blood pressure and ejection time, it did not alter the exercise intensity threshold for ischemic events.

    Area of Science:

    • Cardiovascular Physiology
    • Exercise Stress Testing
    • Pharmacology

    Background:

    • Angina pectoris is characterized by exercise-induced limitations, often due to myocardial oxygen supply-demand mismatch.
    • Understanding the hemodynamic effects of vasodilators during exercise is crucial for managing angina.

    Purpose of the Study:

    • To evaluate the effects of chewable isosorbide dinitrate on exercise capacity and ischemic thresholds in men with angina pectoris.
    • To assess hemodynamic and electrocardiographic responses to exercise after administration of isosorbide dinitrate compared to placebo.

    Main Methods:

    • Sixteen men with angina pectoris underwent a multistage exercise stress test.
    • Subjects were randomly assigned to receive chewable isosorbide dinitrate or placebo.

    Related Experiment Videos

  • Hemodynamic parameters (blood pressure, heart rate), electrocardiographic changes, and systolic time intervals were measured at rest, peak exercise, and recovery.

    • Main Results:

    • Isosorbide dinitrate significantly reduced systolic blood pressure and the triple product (systolic blood pressure x heart rate x ejection time) at rest.
    • Left ventricular ejection time corrected for heart rate was reduced at rest and peak exercise with isosorbide dinitrate.
    • No significant differences in workload capacity or ischemic threshold (measured by triple product) were observed between the vasodilator and placebo groups.

    Conclusions:

    • Chewable isosorbide dinitrate effectively reduces cardiovascular workload and left ventricular ejection time in patients with angina pectoris.
    • Despite hemodynamic changes, isosorbide dinitrate did not alter the threshold for exercise-induced ischemic manifestations in this cohort.