Document Detail


Acute effects of nifedipine versus isosorbide dinitrate on exercise tolerance in patients with isolated coronary artery occlusion and collaterals.
MedLine Citation:
PMID:  2076398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The acute effects of slow-release nifedipine and isosorbide dinitrate on exercise tolerance were compared in nine patients with isolated total coronary artery occlusion showing retrograde filling via collaterals. All patients had a reproducible positive exercise stress test off medication before the study. Each patient was randomized to 10 mg slow-release nifedipine and 5 mg isosorbide dinitrate in a single-blind, cross-over study. The exercise stress test was performed 30 minutes after drug administration. After nifedipine, three patients had a negative exercise stress test, whereas the test was negative after isosorbide dinitrate only in one patient. A significantly higher exercise tolerance was detected at peak exercise after nifedipine than after isosorbide dinitrate, as shown by a longer exercise time (380 +/- 44 vs. 295 +/- 41 seconds, p less than 0.001), a more increased maximum work load (355 +/- 89 vs. 255 +/- 55 W x min, p less than 0.02), and a higher rate-pressure product (30,300 +/- 2,500 vs. 26,100 +/- 2,700, p less than 0.01). In conclusion, these results seem to suggest that nifedipine may have a vasomotor effect on collaterals, since it elevated the threshold of ischemia more than isosorbide dinitrate did in patients with isolated coronary artery occlusion, showing retrograde filling via collaterals.
Authors:
F Barillà; F Pelliccia; A Valente; C Cianfrocca; F Romeo; A Reale
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  4 Suppl 5     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1991-04-24     Completed Date:  1991-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  905-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University of Rome, La Sapienza, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / drug therapy
Angiography
Arterial Occlusive Diseases / drug therapy*
Collateral Circulation / drug effects,  physiology*
Coronary Disease / drug therapy*
Exercise / physiology*
Exercise Test
Female
Humans
Isosorbide Dinitrate / pharmacology*,  therapeutic use
Male
Middle Aged
Nifedipine / pharmacology*,  therapeutic use
Reproducibility of Results
Chemical
Reg. No./Substance:
21829-25-4/Nifedipine; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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