Effect upon myocardial blood-flow in man of beta-blocking agents, isosorbide dinitrate, dipyridamole and their combination.
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The purpose of this study was to evaluate the antianginal and antiischemic effects of isosorbide-5-mononitrate (Mono Mack) in patents unresponsive to its therapy. Thirty eight patients aged 38 to 70 years who had coronary heart disease (CHD) were followed up. Estimation of the number of daily anginal episodes, 24-hour monitoring, EchoCG, bicycle ergometry, tetrapolar rheocardiography, and self-assessment were made. Prior to the follow-up all the patients were treated with nitrosorbide (80-100 mg/day), beta-blockers, ACE inhibitors, disaggregants, and a complex of physico- and psychotherapies. CHD progression was an indication for the use Mono Mack. Its dose was 20 mg twice a day. Following 18-20 days, the efficiency of its use was evaluated. The treatment yielded a clinical effect in all the patients. The total daily number of anginal episodes decreased from 3.9 to 1.2 times. 24-hour monitoring showed an average decrease in the duration of ST-segment depression from 554 to 245 min a day. There was a significant increase in the patients' physical fitness and a trend for cardiac contractility to increase. They felt all better. With clinical improvement, 5 patients had no changes, as evidenced by instrumental studies. It is concluded that Mono Mack is highly effective with dinitrate tolerance, 1.8-fold decrease in the dose of nitrates, and good interaction with other drugs.
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