Coronary circulation in patients with and without coronary artery disease and the effects of chewable isosorbide dinitrate.
Coronary arteriograms of 38 patients with suspected coronary artery disease (CAD) were first evaluated to decide whether or not the disease was present and, if so, whether easily recognizable collateral channels were demonstrated. In this evaluation, we found CAD in 26 of the 38 patients. Eighteen of 21 patients with severe obstructions or occlusions had functioning collateral vessels. The films were then evaluated a second and third time to determine the effects of chewable isosorbide dinitrate (ISDN) on the coronary circulation. Visual inspection of the arteriograms revealed significant increases in 1) the apparent number and diameter of collateral vessels, 2) the opacification of vessels distal to occlusions, and 3) the diameter of coronary arteries following the administration of 2.5, 5, or 10 mg chewable ISDN. Computer analysis of the arteriograms showed an average 16% increase in the diameters of specific segments of major coronary arteries following ISDN. All patients showed some degree of vasodilatation following ISDN; however, patients without CAD consistently showed more vasodilatation than patients with disease. Mean aortic blood pressure decreased an average of 10% following ISDN. These results demonstrate that the chewable form of ISDN reliably dilates the coronary arteries in patients both with and without CAD and enhances the collateral circulation to the ischemic areas in patients with CAD.
D000328:Adult; D000368:Aged; D003097:Collateral Circulation / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate; D008297:Male; D008875:Middle Aged
D007548:Isosorbide Dinitrate