Amelioration of Microvascular Angina with Arginine Supplementation
Authors: Leonard Schwartz
Journal: Annals of Internal Medicine (2003)

Letters21 January 2003Amelioration of Microvascular Angina with Arginine SupplementationLeonard Schwartz, MDLeonard Schwartz, MDToronto General Hospital; Toronto, Ontario M5G 2C4, Canada (Schwartz)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-2-200301210-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Endothelial-dependent vasodilation is impaired in patients with type 1 diabetes mellitus (1), which may contribute to microvascular complications and other clinical sequelae. A 41-year-old woman presented with debilitating exertional angina pectoris. She had a 35-year history of type 1 diabetes mellitus. She also had early retinopathy. Coronary angiography revealed normal epicardial coronary arteries, and an intravenous ergonovine test ruled out large-vessel spasm. A provisional diagnosis of microvascular angina due to endothelial dysfunction was made. Since L-arginine has been shown to improve small-vessel coronary endothelial function (2), arginine supplementation was initiated with two HeartBars (Cooke Pharma, Inc., Belmont, ...References1. Johnstone MT, Creager SJ, Scales KM, Cusco JA, Lee BK, Creager MA. Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. Circulation. 1993;88:2510-6. [PMID: 8080489] CrossrefMedlineGoogle Scholar2. Lerman A, Burnett JC, Higano ST, McKinley LJ, Holmes DR. Long-term L-arginine supplementation improves small-vessel coronary endothelial function in humans. Circulation. 1998;97:2123-8. [PMID: 9626172] CrossrefMedlineGoogle Scholar3. Mullen MJ, Wright D, Donald AE, Thorne S, Thomson H, Deanfield JE. Atorvastatin but not L-arginine improves endothelial function in type I diabetes mellitus: a double-blind study. J Am Coll Cardiol. 2000;36:410-6. [PMID: 10933350] CrossrefMedlineGoogle Scholar4. Maxwell AJ, Zapien MP, Stone PH. Double blind, placebo controlled trial of a medical food for the dietary management of chronic stable angina [Abstract]. Circulation. 2000;102:409(A). Google Scholar5. Schwartz L, Bourassa MG. Evaluation of patients with chest pain and normal coronary angiograms. Arch Intern Med. 2001;161:1825-33. [PMID: 11493123] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Leonard Schwartz, MDAffiliations: Toronto General Hospital; Toronto, Ontario M5G 2C4, Canada (Schwartz) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCellular and Physiological Effects of Arginine in SeniorsAnti-aging effects of l-arginineOster rediscovered – Mega-dose folate for symptomatic atherosclerosis 21 January 2003Volume 138, Issue 2Page: 160KeywordsAnginaAngiographyArginineCoronary arteriesExerciseRetinopathyStable coronary artery diseaseType 1 diabetesVasodilationVitamins ePublished: 21 January 2003 Issue Published: 21 January 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...