What is the clinical evidence from this study?

Study design: Review. Population: Ischaemic heart disease. Intervention: Exercise.

What does this research mean for the field?

Normal coronary arteries dilate during dynamic exercise, whereas stenotic segments in coronary artery disease undergo paradoxical exercise-induced vasoconstriction that contributes to myocardial ischaemia. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 16, 2026European Heart JournalOpen Access

Potential role of coronary vasoconstriction in ischaemic heart disease: effect of exercise

View Full Paper

Ask AI

Bookmark

Key result

Exercise dilates normal coronary arteries up to ~40% but paradoxically triggers vasoconstriction in CAD.

Why the study?

Does exercise induce coronary vasoconstriction in stenotic vessel segments in patients with coronary artery disease?

Population

Patients with coronary artery disease and normal subjects

Design

Review

Authors

OHOtto M. HessInterventional Cardiology MBMartin BüchiTexas Medical Center RKRichard L. KirkeeideMemorial Hermann

Discussion

Member takes

Implication

Exercise-induced stenosis narrowing plays a key role in the pathophysiology of myocardial ischemia and can be mitigated by direct action of vasoactive substances on coronary vasomotion.

Key Points

To examine the mechanisms of exercise-induced coronary vasoconstriction in ischaemic heart disease and assess the therapeutic impact of vasoactive agents.
Measured coronary vasomotion in normal arteries and stenotic vessel segments during supine bicycle exercise in patients with coronary artery disease.
Assessed the reversing and preventive effects of vasoactive medications, including nitroglycerin and the calcium antagonist diltiazem, administered individually and in combination.
Normal coronary arteries exhibited exercise-induced vasodilation of +20% in proximal and +40% in distal segments, whereas coronary artery disease segments showed paradoxical stenosis vasoconstriction.
Vasoactive drugs including nitroglycerin and calcium antagonists prevented exercise-induced vasoconstriction, with the combination of nitroglycerin and diltiazem producing an additive vasodilatory response in stenotic segments.

Structured PICO

Does exercise induce coronary vasoconstriction in stenotic vessel segments in patients with coronary artery disease?

Population

Patients with coronary artery disease and normal subjects

Exposure

Exercise and vasoactive drugs (nitroglycerin, calcium antagonists)

Outcome

Coronary vasomotion (vasodilation or vasoconstriction)surrogate

Exercise-induced stenosis narrowing plays a key role in the pathophysiology of myocardial ischemia and can be mitigated by direct action of vasoactive substances on coronary vasomotion.

Cite This Study

Hess et al. (1990) conducted a review in Ischaemic heart disease. Exercise was evaluated. Normal coronary arteries show vasodilation of proximal (+20%) and distal (+40%) segments during exercise, whereas patients with coronary artery disease experience exercise-induced vasoconstriction.

synapsesocial.com/papers/6a08df49d434fcb6f266dd7e https://doi.org/10.1093/eurheartj/11.suppl_b.58

View Full Paper

Ask AI

Bookmark

Implication

Exercise-induced stenosis narrowing plays a key role in the pathophysiology of myocardial ischemia and can be mitigated by direct action of vasoactive substances on coronary vasomotion.

Potential role of coronary vasoconstriction in ischaemic heart disease: effect of exercise

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Potential role of coronary vasoconstriction in ischaemic heart disease: effect of exercise

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider