Effect of Intravenous Cytochrome G on Capacity for Effort Without Pain in Angina of Effort

Within the past few years, reports have appeared on the effect of Cytochrome C∗ on tissue anoxia. From the clinical point of view, Proger and his co-workers have presented evidence that myocardial anoxia can be relieved by intravenous injection of Cytochrome C, as demonstrated by the prevention or reversal of the electrocardiographic changes induced by breathing 10% oxygen. 1 It is their contention that, under such circumstances, Cytochrome C enhances the uptake of oxygen by the myocardium. Another method of testing the effect of a drug on myocardial anoxia is to determine the capacity for effort without pain in patients who have angina pectoris brought on by effort. Since this method depends on a subjective end-point, it is necessary to use careful controls and a completely “blind” technique, as described by Gold and his coworkers, in order to eliminate variable psychosomatic effects. 2 This method has been used by us in an evaluation of the effect of intravenous aminophylline on angina of effort, and it proved to be a satisfactory investigative technique. 3 The subjects of the study were all selected from the active attendance of the Cardiac Clinic. All of them had either arteriosclerotic or hypertensive heart disease or a combination of both, and all presented the symptom of chest pain on effort. No patients were included in this study who had spontaneous chest pain unrelated to effort, excitement, heavy meals, or very cold weather. Also excluded were patients who showed any clinical evidence of congestive failure. The method consisted of determining the subject's capacity for effort without pain by having him walk back and forth over a standard set of steps until the onset of his usual type of chest pain. The rate of walking was set by the subject himself, and in any subsequent tests on that same subject, he was kept to the same rate.