EXERCISE ECHOCARDIOGRAPHY - A NEW TEST FO R THE ASSESSMENT OF ANTIISCHEMIC DRUG EFFECTS

Exercise echocardiography and exercise electrocardiography were perfor med to test the anti-ischemic effects of isosorbide dinitrates (2x 40 mg) und nisoldipine (2x 10 mg) using a randomized,double-blind,placebo -controlled crossover trial. A total of 24 patients with symptomatic c oronary artery disease and exercise-induced ST segment depression unde rwent 144 investigations (6 in each patient) at the first placebo trea tment, ist and 8th day during treatment with the first drug and the se cond placebo treatment, 1st and 8th day during treatment with the seco nd drug. A wall motion score (sum of 14 segments; wall motion grading: normal = 1, hypokinetic = 2, akinetic = 3, dyskinetic = 4) and ST dep ression at the exercise were used to assess the anti-ischemic effects. Both drugs reduced the number of exercise-induced wall motion abnorma lities on the maximal comparable exercise level in comparison to place bo treatment. The wall motion score on the maximal comparable exercise level during placebo treatment was 25.5 +/- 6.9, during isosorbide di nitrate treatment (1 day) 23.5 +/- 7.2 and 23 +/- 6.7 (8th day; for bo th treatment days, p less than or equal to 0.001 vs. placebo treatment ), and during nisoldipine treatment (1st day) 23.6 +/- 5.9 and 23 +/- 6.8 (8th day; p less than or equal to 0.001). ST segment depression ch anged at exercise during first placebo treatment to 0.153 +/- 0.068 mV , during ISDN treatment to 0.102 +/- 0.055 (1st day, p < 0.001) and to 0.117 +/- 0.056 (8th day, p < 0.001). ST seg ment depression during n isoldipine treatment was 0.121 +/- 0.075 mV on the 1st day (p less tha n or equal to 0.002) and 0.120 +/- 0.071 mV on the 8th day (p < 0.001) . Exercise echocardiography can be used to test anti-ischemic drug eff ects. There were no differences in the reduction of exercise-induced i schemia between the two drugs.