[The anti-ischemic effect of isosorbide dinitrate alone and in combination with gallopamil and propranolol].

In 18 patients (17 male and 1 female, 40 to 63 years old) with coronary heart disease, a randomized double-blind study was carried out to investigate in comparison to placebo, the antiischemic effects of 5, 10 and 20 mg isosorbide dinitrate (ISDN) alone and in combination with gallopamil (G: 25 and 50 mg) or 80 mg propranolol (P: 80 mg) on the ischemic ST-segment-depression in standardized exercise ECGs. ST-depression following administration of ISDN alone was reduced significantly and dose-dependently: following 5 mg from 1.32 +/- 1.14 to 1.0 +/- 0.85 mm (-25.2%; p less than 0.05), 10 mg from 1.17 +/- 0.85 to 0.91 +/- 0.69 mm (-21.7% n.s.) and 20 mg from 1.19 +/- 0.5 to 0.52 +/- 0.57 mm (-53.6%; p less than 0.001). In combination with gallopamil (G: 25 and 50 mg) or propranolol (P) reduction of ST-depression was more pronounced: by 5 mg ISDN with 25 mg G from 1.32 +/- 1.14 to 0.7 +/- 0.71 mm (-46.4%; p less than 0.05), with 50 mg G from 1.32 +/- 1.14 to 0.8 +/- 0.83 mm (-38.8%; p less than 0.01), with 80 mg P from 1.32 +/- 1.14 to 0.28 +/- 0.35 mm (-79.5% p less than 0.01), by 10 mg ISDN combined with 25 mg G from 1.17 +/- 0.85 to 0.69 +/- 0.6 mm (-40.7%; p less than 0.05), with 50 mg G from 1.17 +/- 0.85 to 0.66 +/- 0.62 mm (-43.5%; p less than 0.05), with 80 mg P from 1.17 +/- 0.85 to 0.64 +/- 0.78 mm (-46.4%; p less than 0.01), and by 20 mg ISDN with 25 mg G from 1.19 +/- 0.5 to 0.42 +/- 0.43 mm (-62.6%; p less than 0.001), with 50 mg G from 1.19 +/- 0.5 to 0.39 +/- 0.45 mm (-65.2%; p less than 0.001) and with 80 mg P from 1.19 +/- 0.5 to 0.05 +/- 0.16 mm (-95.8%; p less than 0.001).