The beneficial effect of diltiazem on exercise-induced ST depression, measured by body surface mapping, in stable effort angina pectoris.

The effect of diltiazem, a calcium antagonist, was examined in eight male patients with stable effort angina pectoris by means of multistage treadmill testing using body surface mapping. The area and severity of exercise-induced ST depression after 90 mg of diltiazem administered orally three hours before exercise were compared with those without diltiazem. Although the same workload was performed, the area and severity of exercise-induced ST depression were significantly diminished (P less than 0.005) after diltiazem. The reproducibility of these observations was confirmed in two of the eight patients studied and in three other patients. Because exercise-induced ST depression in patients with coronary artery disease is generally believed to reflect myocardial ischemia, our results provide objective evidence that diltiazem is able to reduce the exercise-induced myocardial ischemia in effort angina pectoris.