Related Experiment Video
Updated: Aug 4, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
[Sublingual isosorbide-5 mononitrate during coronary arteriography. Comparison with sublingual nitroglycerin]
A E Moreira1, S Arie, E L Costa
1Instituto do Coração do Hospital das Clínicas, FMUSP.
Purpose:
To evaluate the effect of sublingual isosorbide-5 mononitrate (ISMN) and nitroglycerin (NTG) on luminal diameter of epicardial coronary arteries, mean arterial pressure and deleterious effects.
Methods:
Fifty patients were submitted to cardiac catheterization and coronary arteriography, at baseline, and 5 min after sublingual administration of ISMN, group A (GA) or NTG, group B (GB).
Results:
Reference vessel diameter increased in both groups, without statistical significance. In GA and GB, a decrease (1.66 mmHg) and an increase (0.79 mmHg) in mean arterial pressure, respectively, were demonstrated (p = 0.123). There were no deleterious effects with the use of these drugs.
Conclusion:
Sublingual ISMN is an alternative to administration of NTG during coronary arteriography, and represents a therapeutic alternative to ischemic heart disease treatment.
Related Concept Videos
Antianginal Drugs: Nitrates and β-Blockers
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...
Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Acute Coronary Syndrome III: Diagnostic Studies

