To determine the effects of heparin exercise treatment on the coronary collateral flow reserve, exercise thallium-201 myocardial perfusion images were obtained with the same work-load before and late after heparin exercise treatment (17 ± 2 months, mean ± S.E.). In six patients with stable effort angina, to develop the collateral circulation, treadmill exercise was performed 20 times for 2-3 weeks with pretreatment with a single intravenous dose of heparin (5000 IU). The coronary collateral flow reserve was measured quantitatively as a severity score by analysis of exercise thallium-201 myocardial perfusion images. The severity score was decreased from 11 976 ± 1722 to 5531 ± 1967 (P < 0.05) long after heparin exercise treatment. The ST segment depression at the time of peak exercise was also decreased from 0.15 ± 0.02 mV to 0.05 ± 0.02 mV. In an additional five medically treated patients, these indexes remained unchanged during 18 ± 3 months of follow-up period. These findings demonstrate that the coronary collateral flow reserve is significantly enhanced with heparin exercise treatment. These preliminary results lend support for heparin exercise treatment as one of the possible therapeutic modalities for treating patients with chronic stable effort angina. © 1993.
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