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[Isosorbide-dinitrate in myocardial perfusion (author's transl)].

R Wolf, P Pretschner, H J Engel

    Zeitschrift Fur Kardiologie
    |October 1, 1979
    PubMed
    Summary

    Isosorbide dinitrate (ISDN) improved myocardial perfusion in patients with coronary artery disease. The drug normalized exercise-induced perfusion defects, reducing local oxygen consumption and angina symptoms.

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    Area of Science:

    • Cardiology
    • Nuclear Medicine
    • Pharmacology

    Background:

    • Coronary artery disease (CAD) causes myocardial ischemia and angina.
    • Assessing myocardial perfusion is crucial for managing CAD.
    • Isosorbide dinitrate (ISDN) is a vasodilator used in treating angina.

    Purpose of the Study:

    • To evaluate the effect of sublingual isosorbide dinitrate (ISDN) on myocardial perfusion in patients with severe CAD.
    • To assess ISDN's impact on exercise-induced ischemic defects and angina symptoms.

    Main Methods:

    • 14 patients with severe CAD and angina underwent 201-Thallium myocardial scintigraphy.
    • Scintigraphy was performed at rest and during exercise, with and without ISDN (10 mg sublingually).
    • All medications, except sublingual nitroglycerin, were withheld for one week prior to each scan.

    Main Results:

    • Isosorbide dinitrate (ISDN) normalized 64% of exercise-induced perfusion defects.
    • In patients with complete angina relief, 76% of defects normalized.
    • ISDN led to a more homogeneous Thallium distribution, indicating reduced myocardial oxygen consumption.

    Conclusions:

    • Sublingual isosorbide dinitrate (ISDN) significantly improves myocardial perfusion in patients with severe coronary artery disease.
    • ISDN effectively reduces exercise-induced ischemic defects and alleviates angina.
    • The drug enhances perfusion homogeneity, suggesting a decrease in myocardial oxygen demand.

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