Figure 209-1

Acute effects of nitrates on exercise testing in syndrome X. The administration of isosorbide dinitrate (ISDN, 5 mg sublingual) significantly improved exercise test variables in patients with chronic stable angina and documented coronary artery disease (right panel). In contrast, ISDN caused a worsening of exercise variables in a significant number of patients with syndrome X (left panel). ST, ST segment; RPP, rate pressure product.

(Modified from Lanza GA, Manzoli A, Bia E, et aL Acute effects of nitrates on exercise testing in patients with syndrome X: Clinical and pathophysiological implications. Circulation 1994; 90:2695, by permission.)