K. Node et al., INCREASED RELEASE OF NITRIC-OXIDE IN ISCHEMIC HEARTS AFTER EXERCISE IN PATIENTS WITH EFFORT ANGINA, Journal of the American College of Cardiology, 32(1), 1998, pp. 63-68
Objectives. The aim of this study was to determine whether the release
of nitric oxide (NO) from the ischemic heart increases during exercis
e in patients with effort angina. Background. Myocardial ischemia incr
eases NO production in the canine heart, but no such increase has been
demonstrated in the ischemic human heart. Methods. Fifteen patients w
ith effort angina underwent supine ergometer exercise tests. All patie
nts had severe proximal stenosis (>90%) in the left anterior descendin
g 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 (Delta VA[NO]
) was affected by exercise in the control subjects. In patients with e
ffort angina, neither variable differed from that in the control group
at rest; however, exercise markedly decreased LER and significantly i
ncreased Delta VA(NO) (from 4.7 +/- 0.3 to 16.5 +/- 1.6 mu mol/liter,
p < 0.001) in the patient group. The extent of decrease in LER was sig
nificantly correlated with the extent of increase in Delta VA(NO) in t
he patients with effort angina (r(2) = -0.837, p < 0.001). Conclusions
. Provocation of myocardial ischemia by exercise stress increases NO p
roduction in the hearts of patients with effort angina. (C) 1998 by th
e American College of Cardiology.