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July 1, 1984CirculationOpen Access

Reflex constriction of significant coronary stenosis as a mechanism contributing to ischemic left ventricular dysfunction during isometric exercise.

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Why the study?

Does intracoronary nitroglycerin prevent reflex constriction of significant coronary stenosis and ischemic left ventricular dysfunction during isometric exercise?

Population

11 patients with at least one significant coronary stenosis each, undergoing cardiac catheterization

Comparison

Handgrip sustained for 4.5 min at 25% of maximum… vs Handgrip alone

Design

Other

Follow-up

Acute (during cardiac catheterization)

Authors

BBB. Greg BrownALA B LeeEBEdward L. Bolson

Discussion

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Overview

Supports vasoconstriction as dominant mechanism in exercise ischemia; hypothesis-generating, should not yet change practice.

Structured PICO

Does intracoronary nitroglycerin prevent reflex constriction of significant coronary stenosis and ischemic left ventricular dysfunction during isometric exercise?

P
Population
11 patients with at least one significant coronary stenosis each, undergoing cardiac catheterization
I
Intervention
Handgrip sustained for 4.5 min at 25% of maximum with simultaneous infusion of intracoronary nitroglycerin (50 micrograms over 4 min) directly into the diseased vessel
C
Comparator
Handgrip alone (first handgrip test without nitroglycerin)
O
Outcome
Cardiovascular response assessed by hemodynamic and computer-assisted measurements of stenosis (pulmonary capillary wedge pressure, heart rate-systolic pressure product, luminal area, stenotic flow resistance)surrogate

Coronary vasoconstriction, rather than increased pressure-rate product, is the dominant mechanism for ischemic left ventricular dysfunction during isometric exercise in patients with significant coronary stenoses, and this can be reversed by intracoronary nitroglycerin.

Cite This Study

Brown et al. (1984) studied this question.

synapsesocial.com/papers/6a1c5e7ebc71fb1015a97429https://doi.org/10.1161/01.cir.70.1.18
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