THE DEVELOPMENT AND REVERSAL OF TOLERANCE TO ANTIANGINAL EFFECT OF ISOSORBIDE DINITRATE IN PATIENTS WITH EFFORT ANGINA

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• The development and reversal of tolerance to the hemodynamic and antianginal effects of isosorbide dinitrate in a sustained release from (ISDN-SR) were investigated in 11 male patients (mean age 58.9 y.o.) with stable effort angina. Treadmill exercise test, evaluation of hemodynamic parameters and measurement of plasma ISDN concentrations were performed during the control period on the 1st, 7th and 14th days of therapy with 40 mg of re-administered after a 72 h placebo period (17th day). Initially, exercise tolerance time (ETT) was prolonged significantly (p<0.001) by ISDN-SR from 257±50 sec in the control period to 434±55 sec on day 1. This prolongation was significantly reduced with sustained therapy and ETT was shortened to 332±69 sec on the 7th day (p<0.01 vs day 1) and 326±73 sec on the 14th day (p<0.01 vs day 1). The effects of ISDN-SR initially observed were restored after a 72 h placebo period and ETT was increased significantly (p<0.01 vs control) and systolic blood pressure was decreased (p<0.001 vs control) by ISDN-SR on day 1. These changes were also diminished significantly (p<0.01 vs day 1) with sustained therapy and were restore after a 72 h nitrate-free interval. The average plasma ISDN concentration was significantly higher during sustained than during acute therapy (p<0.01). It is concluded that partial tolerance to hemodynamic and antianginal effects developed during sustained (1 week) therapy with ISDN-SR and was reversed after a 72 h nitrate-free interval.

• 社団法人日本循環器学会の論文
• 1989-05-20

著者

• Katsuki Takaaki

  Department of Cardiology, Jichi Medical School

• Hosoda Saichi

  Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical College

• Yaginuma Toshio

  Department Of General Internal Medicine Omiya Medical Center Jichi Medical School

• Yaginuma Toshio

  Omiya Medical Center Jichi Medical University School Of Medicine

• NATSUME TAKASHI

  Department of Internal Medicine, National Cardiovascular Center

• Hosoda S

  Cardiovascular Institute Tokyo Women's Medical College

• Kimura Yutaka

  Tochigi Ischemic Heart Disease Research Group

• WATABIKI Hisao

  Department of Cardiology, Jichi Medicical School

• KOMABA Akira

  Department of Cardiology, Jichi Medicical School

• FUJII Mikihisa

  Department of Cardiology,Jichi Medical School

• KAWADA Yutaka

  Department of Cardiology,Jichi Medical School

• Toyosaki Nobuo

  Department of Cardiology, Jichi Medical School

• NATSUME TAKASHI

  The Department of Cardiology, Jichi Medical school

• HASEGAWA HIDEMI

  Department of Cardiology, Jichi Medical School

• SUZUKI SHIGEHIDE

  Department of Cardiology, Jichi Medical School

• Yaginuma Toshio

  Department Of Cardiology Jichi Medical School

• Yaginuma Toshio

  Department Of Cardiology Jichi Medical School Tochigi

• Natsume Takashi

  The Department Of Cardiology Jichi Medical School

• Natsume Takashi

  Department Of Cardiology Jichi Medical School

• Hosoda Saichi

  Cardiovascular Institute Tokyo Women's Medical College

• Komaba Akira

  Department Of Cardiology Jichi Medical School Tochigi

• Fujii Mikihisa

  Department Of Cardiology Jichi Medical School

• Toyosaki Nobuo

  Department Of Cardiology Jichi Medical School

• Watabiki Hisao

  Department Of Cardiology Jichi Medical School

• Katsuki Takaaki

  Department Of Cardiology Jichi Medical School

• Hasegawa Hidemi

  Department Of Cardiology Jichi Medical School

• Suzuki Shigehide

  Department Of Cardiology Jichi Medical School

• Hosoda Saichi

  Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical College

• Hosoda Saichi

  Dept. Of Cardiol. Jichi Med. Sch. Tochigi

• Hosoda Saichi

  Division Of Cardiology Jich Medical School

• Yaginuma Toshio

  Division Of Cardiology Jich Medical School

• Hosoda Saichi

  Department Of Cardiology And Internal Medicine

• Hosoda Saichi

  Department Of Cardioangiology And Internal Medicine Jichi Medical School

• Kawada Yutaka

  Department Of Cardiology Jichi Medical School

• Katsuki Taka'aki

  Dept. Of Cardiol. Jichi Med. Sch. Tochigi

• Yaginuma Toshio

  Department Of Cardiology And Medicine Jichi Medical School

• Natsume Takashi

  Department Of Cardiology. Jichi Medical School

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