Related Experiment Video

Updated: Jul 18, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
09:33

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

Impaired nitrate-mediated dilatation could reflect nitrate tolerance in patients with coronary artery disease

Rui Hu1, Chung Wah Siu, Elizabeth-Oy Lau

  • 1Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.

International Journal of Cardiology
|December 19, 2006
PubMed

Insights

Nitrate use impairs nitrate-mediated dilatation (NMD) in coronary artery disease (CAD) patients, suggesting NMD can indicate nitrate tolerance. This study evaluated NMD in 243 CAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Vascular Biology

Background:

  • Nitrate tolerance is a significant clinical issue in managing coronary artery disease (CAD).
  • Nitrate-mediated dilatation (NMD) assesses vascular response to nitrates.
  • Understanding factors affecting NMD is crucial for optimizing nitrate therapy.

Purpose of the Study:

  • To determine if nitrate use impairs NMD in CAD patients.
  • To investigate if NMD reflects nitrate tolerance in CAD.
  • To identify determinants of NMD in CAD patients.

Main Methods:

  • 243 CAD patients were recruited before coronary angiography.
  • Brachial artery flow-mediated dilatation (FMD) and NMD were measured.
  • Gensini score assessed CAD severity; regression analysis identified NMD determinants.

Main Results:

  • NMD progressively decreased in control, non-nitrate users, and nitrate users with CAD (P<0.001).
  • Nitrate use was an independent determinant of impaired NMD.
  • In high Gensini score patients, nitrate users showed significantly lower NMD than non-users (P<0.001).

Conclusions:

  • Nitrate use independently impairs NMD in CAD patients.
  • Impaired NMD may serve as a comprehensive index of nitrate tolerance in CAD.
  • Findings highlight the impact of nitrate therapy on vascular function in CAD.
Abstract

More Related Videos

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Related Concept Videos

Nitric Oxide Signaling Pathway01:28

Nitric Oxide Signaling Pathway

Nitric oxide (NO), an inorganic gas, acts as a potent second messenger in most animal and plant tissues. NO diffuses out of the cells that produce it and enters the neighboring cells to generate a downstream response. NO synthase (NOS) catalyzes NO production by the deamination of the amino acid arginine. There are three isoforms of NOS. Endothelial cells have endothelial NOS (eNOS), nerve and muscle cells have neuronal NOS (nNOS), and macrophages produce inducible NOS (iNOS) upon exposure to...
Antihypertensive Drugs: Vasodilators01:23

Antihypertensive Drugs: Vasodilators

Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
Antianginal Drugs: Nitrates and &#946;-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...