Influence of Nitroglycerine on Myocardial Metabolism of Cyclic AMP, Cyclic GMP, Lactate, Free Fatty Acids, and Glucose at Rest and During Exercise in Patients with Coronary Heart Disease
At present it is generally accepted that in resting conditions the antianginal effect of nitrates is due to a reduction of ventricular pre-and afterload [2, 10]. Parker et al.  did not observe any change in coronary blood flow (CBF) at rest and during exercise after administration of nitroglycerin (NTG). In contrast, Lichtlen et al.  found a reduction of exercise CBF due to the action of isosorbide dinitrate, when compared with the control values before drug administration. Atrial pacing induced signs of myocardial ischemia, particularly myocardial lactate (LA) release, may be alleviated by NTG . In normal individuals without obvious coronary heart disease (CHD), during physical activity a reduction of myocardial utilization of free fatty acids (FFA) and glucose (G) was observed together with an enhanced myocardial utilization of lactate, when compared with the control values at rest . However, studies on the effect of ergometric exercise on myocardial metabolism and the influence of nitrates on it in patients with proven CHD are sparse. Therefore, the intention of this study was to investigate the myocardial metabolism of the substrates FFA, LA, and G as well as of cyclic 3,5-AMP and cyclic 3,5-GMP in patients with coronary heart disease at rest and during exercise before and after administration of nitroglycerin.
KeywordsCoronary Blood Flow Myocardial Oxygen Consumption Atrial Pace Myocardial Metabolism Isosorbide Dinitrate
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- 1.Abiko Y, Ichihara K, Izumi T (1979) Effects of antianginal drugs on ischemic myocardial metabolism. In: Abiko Y, Winbury M (eds) Ischemic myocardium and antianginal drugs. Raven, New York, p 213Google Scholar
- 2.Dobbs W, Povalski HJ (1977) Coronary circulation, angina pectoris, and antianginal drugs. In: Antonaccio (ed) Cardiovascular pharmacology. Raven, New York, p 461Google Scholar
- 4.Gutmann I, Wahlefeld AW (1974) Laktat. In: Bergmeyer (ed) Methoden der enzymatischen Analyse, 3rd edn. Chemie, Weinheim, p 1510Google Scholar
- 6.Keul J, Doll E, Steim E, Homburger H, Kern H, Singer H, Reindell H (1965) Über den Stoffwechsel des menschlichen Herzens. I. Die Substratversorgung des menschlichen Herzens in Ruhe, während und nach körperlicher Arbeit. Pfluegers Arch 282: 1Google Scholar
- 9.Kupper W, Bleifeld W (1980) Effect of nitrates on myocardial blood flow, myocardial extraction and hemodynamics during angina pectoris. In: Rudolph L, Schrey A (eds) Nitrate II, Wirkung auf Herz und Kreislauf. Urban & Schwarzenberg, München Wien Baltimore, p 86–88Google Scholar
- 16.Sugiura M (1978) Effects of various drugs on myocardial cyclic AMP. Nagoya J Med Sei 40: 1Google Scholar