[The relationship between the pathogenetic mechanisms of effort stenocardia and the pharmacodynamics of anti-anginal agents]

A single administration of nitroglycerin, corinfar, anapriline was studied for effects on exercise tolerance in 33 patients with exercise-induced angina with varying adrenergic vasoconstriction during exercise estimated by responses to pratsiol. The effect was found to be related to the degree of functional vasoconstriction. It is concluded that there is a pathogenetic heterogeneity of angina on effort in which in 57% of patients having high coronary reserve, adrenergic vasoconstriction along with organic changes in of great value in the genesis of myocardial ischemia during exercise. In 33% patients with low coronary reserve, the major role is played by organic changes in the coronary bed and vasoconstrictive responses are unassociated with adrenergic exposure. Only in 12% of patients the functional component of coronary vasoconstriction is lacking.