| Antianginal drug effects on normal, ischemic and scar myocardial segments in man. | |
| | |
MedLine Citation:
|
PMID: 6442004 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
In order to assess acute effects of nitroglycerin, nifedipine and metoprolol on normal, ischemic and scar myocardial segments in man, non-invasive hemodynamic and radionuclide measurements of left ventricular function were performed. Sixteen patients with single left anterior descending (LAD) disease were studied at rest and during exercise: 9 patients with angina and exercise-induced ischemia (LAD stenosis) and 7 patients with previous transmural myocardial infarction and no ischemic changes at thallium imaging (LAD occlusion). Effects on regional ejection fraction were compared between involved antero-septal and normal postero-lateral areas. Global ejection fraction at rest was unchanged after nitroglycerin, increased after nifedipine and decreased after metoprolol. In patients with ischemia, improvement in exercise ejection fraction after all drugs was due to increased regional ejection fraction in ischemic segments, i.e. a real anti-ischemic effect could be demonstrated. In regions of myocardial scar, regional ejections fraction was not changed after either drug. In normal areas, regional ejection fraction remained unchanged after nitroglycerin and nifedipine but decreased after acute beta-blockade. Despite the very similar anti-ischemic effects of all drugs, underlying hemodynamic mechanisms were quite different: Reduction in preload and afterload after nitroglycerin, vasodilatation and reflex sympathetic activity after nifedipine and reduction in double product and contractility after metoprolol. Thus, the mode of action of nitroglycerin, nifedipine and metoprolol on normal, ischemic and scar myocardial segments could be demonstrated in man. Non-invasive antianginal drug testing as shown in this study should allow optimal medical therapy for patients with chronic ischemic heart disease.(ABSTRACT TRUNCATED AT 250 WORDS) |
| | |
Authors:
|
M Pfisterer; R Fridrich; F Burkart |
Related Documents
:
|
23386234 - Post-stress perfusion abnormalities detected on myocardial perfusion single-photon emis... 6981994 - Continuous monitoring of left ventricular performance with the computerized nuclear pro... 2585654 - Resting gated pool ejection fraction: a poor predictor of perioperative myocardial infa... 3578004 - Assessment of left ventricular diastolic filling by two-dimensional echocardiography. 12660924 - Cardiac valves in patients with q fever endocarditis: microbiological, molecular, and h... 11590904 - Restoration of atrial mechanical function after successful radio-frequency catheter abl... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Scandinavian journal of clinical and laboratory investigation. Supplementum Volume: 173 ISSN: 0085-591X ISO Abbreviation: Scand. J. Clin. Lab. Invest. Suppl. Publication Date: 1984 |
Date Detail:
|
Created Date: 1985-04-02 Completed Date: 1985-04-02 Revised Date: 2008-11-21 |
Medline Journal Info:
|
Nlm Unique ID: 2984789R Medline TA: Scand J Clin Lab Invest Suppl Country: NORWAY |
Other Details:
|
Languages: eng Pagination: 65-73 Citation Subset: IM |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angina Pectoris / prevention & control* Coronary Disease / drug therapy* Female Heart / drug effects Humans Male Metoprolol / pharmacology, therapeutic use* Middle Aged Myocardial Contraction / drug effects Nifedipine / pharmacology, therapeutic use* Nitroglycerin / pharmacology, therapeutic use* Physical Exertion Stroke Volume / drug effects |
| Chemical | |
Reg. No./Substance:
|
21829-25-4/Nifedipine; 37350-58-6/Metoprolol; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Inhibition of bacterial growth by tetracycline-impregnated enamel and dentin.
Next Document: Glyceryltrinitrate as a problem in industry.