Influence of Isosorbide Dinitrate and Mononitrate on the Ejection Fraction and Wall Motion Parameters at Rest and Under Exercise in Patients with Coronary Heart Disease

Stauch, M; Kress, P.; Geffers, H.; Nechwatal, W; Bitter, F.; Sigel, H; Adam, W. E.

doi:10.1007/978-3-642-68085-4_63

Cited by 4 publications

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“…Furthermore, it seemed possible that effects on ECG and symptoms were divergent from the effect on ventricular function. Therefore, a functional study was conducted after 7 days of nitrate administration [13][14][15].Nitrates are often used in combination with other antianginal drugs. Drugs reducing myocardial oxygen demand by direct action on the muscle seem particularly suitable for combination with vasoactive nitrates [16][17][18][19].…”

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confidence: 99%

Lack of tolerance after chronic administration of controlled-release isosorbide-5-mononitrate

Stauch

Großmann

Wanjura

et al. 1990

Eur J Clin Pharmacol

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The effect of a controlled-release formulation of isosorbide-5-mononitrate (IS-5-MN) was studied in patients with coronary heart disease (CHD), with the aim of comparing the acute effect with that after chronic administration on parameters of ischemia. To determine whether any tolerance developed, several aspects of ischemia were observed: ECG signs, clinical parameters, and left ventricular function. Fifteen patients with angiographically proven CHD were examined with 12-lead exercise ECG before, 2 h and 4 h after the first dose and after 10 days of therapy with 60 mg IS-5-MN (Coleb-Duriles) once daily. After 7 days, three radionuclide ventriculographies were performed: control, 2 h after nitrate and 2 h after 75 mg gallopamil. Plasma concentrations of IS-5-MN were measured before every exercise test. The results showed a reduction of total ST-segment depression from 0.59 mV to 0.29 mV after 2 h (NS) and 4 h (P less than 0.05) on the 1st day and from 0.48 mV to 0.32 mV (P less than 0.05) and 0.31 mV (NS) after 10 days. The severity of angina pectoris was diminished by about 50%. The effect on exercise duration and time to ST-segment depression by more than 0.1 mV remained unchanged after 10 days, whereas the effect on blood pressure, heart rate and time to onset of angina was attenuated. The mean decrease in ejection fraction (EF) from rest to exercise was reduced from--5.9% to -1.9% (P less than 0.05) after nitrate, while an increase of +1.4% was seen after gallopamil (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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confidence: 99%