TY - JOUR
T1 - Cigarette smoking-induced coronary vasoconstriction in atherosclerotic coronary artery disease and prevention by calcium antagonists and nitroglycerin
AU - Winniford, Michael D.
AU - Jansen, Donald E.
AU - Reynolds, Gary A.
AU - Apprill, Phillip
AU - Black, William H.
AU - Hillis, L. David
N1 - Funding Information:
From the Department of Internal Medicine (Cardiovascular Division], the University of Texas Health Science Center, Dallas, Texas. This work was supported by the Texas Affiliate of the American Heart Association, Dallas, Texas. Manuscript received July 18, 1986; revised manuscript received September 4, 1986, accepted September 5,1986.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1987/2/1
Y1 - 1987/2/1
N2 - In patients with coronary artery disease, cigarette smoking increases myocardial oxygen demand but may cause an inappropriate α-adrenergically mediated fall in myocardial oxygen supply. This study was performed to determine if smoking-induced coronary vasoconstriction is prevented by nitroglycerin, verapamil or nifedipine treatment. In 25 smokers with coronary artery disease (20 men, 5 women, aged 32 to 65 years), heart rate-systolic arterial pressure double product and coronary sinus blood flow (thermodilution) were measured before and during smoking both before and 30 to 60 minutes after administration of saline solution (n = 5, control subjects); nifedipine, 10 mg sublingually (n = 6); verapamil, 10 mg intravenously (n = 7); or nitroglycerin, 0.4 mg sublingually (n = 7). During the first smoking period, double product increased, but coronary sinus flow did not change or decreased. During the second smoking period, in the control subjects double product and coronary sinus flow responded in a manner similar to that observed previously. In those given nifedipine, double product did not change, but coronary sinus flow increased (-4 ± 5% during the first smoking period [before nifedipine] and 17 ± 12% during the second period [after nifedipine], p < 0.01). In those given verapamil, double product and coronary sinus flow increased during smoking (-12 ± 8% during the first smoking period [before verapamil], 10 ± 9% during the second period [after verapamil], p < 0.01). In those given nitroglycerin, double product and coronary sinus flow increased with smoking (-1 ± 17% during the first smoking period [before nitroglycerin], 31 ± 18% during the second [after nitroglycerin], p < 0.01). Thus, smoking-induced coronary vasoconstriction is prevented by calcium antagonist drugs and nitroglycerin; these agents may improve the myocardial oxygen supply:demand relation during smoking.
AB - In patients with coronary artery disease, cigarette smoking increases myocardial oxygen demand but may cause an inappropriate α-adrenergically mediated fall in myocardial oxygen supply. This study was performed to determine if smoking-induced coronary vasoconstriction is prevented by nitroglycerin, verapamil or nifedipine treatment. In 25 smokers with coronary artery disease (20 men, 5 women, aged 32 to 65 years), heart rate-systolic arterial pressure double product and coronary sinus blood flow (thermodilution) were measured before and during smoking both before and 30 to 60 minutes after administration of saline solution (n = 5, control subjects); nifedipine, 10 mg sublingually (n = 6); verapamil, 10 mg intravenously (n = 7); or nitroglycerin, 0.4 mg sublingually (n = 7). During the first smoking period, double product increased, but coronary sinus flow did not change or decreased. During the second smoking period, in the control subjects double product and coronary sinus flow responded in a manner similar to that observed previously. In those given nifedipine, double product did not change, but coronary sinus flow increased (-4 ± 5% during the first smoking period [before nifedipine] and 17 ± 12% during the second period [after nifedipine], p < 0.01). In those given verapamil, double product and coronary sinus flow increased during smoking (-12 ± 8% during the first smoking period [before verapamil], 10 ± 9% during the second period [after verapamil], p < 0.01). In those given nitroglycerin, double product and coronary sinus flow increased with smoking (-1 ± 17% during the first smoking period [before nitroglycerin], 31 ± 18% during the second [after nitroglycerin], p < 0.01). Thus, smoking-induced coronary vasoconstriction is prevented by calcium antagonist drugs and nitroglycerin; these agents may improve the myocardial oxygen supply:demand relation during smoking.
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U2 - 10.1016/0002-9149(87)90785-5
DO - 10.1016/0002-9149(87)90785-5
M3 - Article
C2 - 3101478
AN - SCOPUS:84879282849
VL - 59
SP - 203
EP - 207
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 4
ER -