OBJECTIVES: The aim of this study was to determine whether the release of nitric oxide (NO) from the ischemic heart increases during exercise in patients with effort angina. BACKGROUND: Myocardial ischemia increases NO production in the canine heart, but no such increase has been demonstrated in the ischemic human heart. METHODS: Fifteen patients with effort angina underwent supine ergometer exercise tests. All patients had severe proximal stenosis (>90%) in the left anterior descending coronary artery. The control group consisted of 17 subjects without coronary artery disease or systemic hemodynamic abnormalities. RESULTS: Neither the lactate extraction ratio (LER) nor the difference in NO concentration between coronary venous and arterial blood (deltaVA[NO]) was affected by exercise in the control subjects. In patients with effort angina, neither variable differed from that in the control group at rest; however, exercise markedly decreased LER and significantly increased deltaVA(NO) (from 4.7 +/- 0.3 to 16.5 +/- 1.6 micromol/liter, p < 0.001) in the patient group. The extent of decrease in LER was significantly correlated with the extent of increase in deltaVA(NO) in the patients with effort angina (r2 = -0.837, p < 0.001). CONCLUSIONS: Provocation of myocardial ischemia by exercise stress increases NO production in the hearts of patients with effort angina.
OBJECTIVES: The aim of this study was to determine whether the release of nitric oxide (NO) from the ischemic heart increases during exercise in patients with effort angina. BACKGROUND:Myocardial ischemia increases NO production in the canine heart, but no such increase has been demonstrated in the ischemichuman heart. METHODS: Fifteen patients with effort angina underwent supine ergometer exercise tests. All patients had severe proximal stenosis (>90%) in the left anterior descending coronary artery. The control group consisted of 17 subjects without coronary artery disease or systemic hemodynamic abnormalities. RESULTS: Neither the lactate extraction ratio (LER) nor the difference in NO concentration between coronary venous and arterial blood (deltaVA[NO]) was affected by exercise in the control subjects. In patients with effort angina, neither variable differed from that in the control group at rest; however, exercise markedly decreased LER and significantly increased deltaVA(NO) (from 4.7 +/- 0.3 to 16.5 +/- 1.6 micromol/liter, p < 0.001) in the patient group. The extent of decrease in LER was significantly correlated with the extent of increase in deltaVA(NO) in the patients with effort angina (r2 = -0.837, p < 0.001). CONCLUSIONS: Provocation of myocardial ischemia by exercise stress increases NO production in the hearts of patients with effort angina.
Authors: Biao Lei; Ken Matsuo; Volodymyr Labinskyy; Naveen Sharma; Margaret P Chandler; Anna Ahn; Thomas H Hintze; William C Stanley; Fabio A Recchia Journal: Proc Natl Acad Sci U S A Date: 2005-05-03 Impact factor: 11.205