Document Detail


Comparison of verapamil versus felodipine on heart rate variability after acute myocardial infarction.
MedLine Citation:
PMID:  9068509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A depressed heart rate variability (HRV) is a powerful predictor of poor outcome in myocardial infarction patients. The beneficial effect of specific interventions on its recovery has been reported, but data concerning calcium antagonists are scarce. We evaluated the effect of a phenylalkylamine derivative, verapamil, and a dihydropyridine derivative, felodipine, on time- and frequency-domain measurements of HRV by 24-hour Holter monitoring in 60 patients with acute myocardial infarction (AMI). After a first Holter recording (65 +/- 8 hours from the onset of symptoms), patients were randomly assigned to continue standard treatment or to also receive verapamil retard (120 mg 3 times daily) or felodipine extended-release (10 mg/day). Holter recording was repeated after 7 days. After verapamil, mean RR interval increased from 823 +/- 92 to 907 +/- 95 ms and the SD of all normal RR (NN) intervals (SDNN) from 99 +/- 24 to 120 +/- 30 ms (p < 0.01); the root mean square successive difference (r-MSSD) and the percent of differences between adjacent NN intervals > 50 ms (pNN50) also increased (p < 0.01). After felodipine, only SDNN increased (p < 0.01). Regarding frequency-domain measurements, after receiving verapamil, very low frequency, low- and high-frequency powers increased (p < 0.01), whereas the low- to high-frequency ratio decreased (p < 0.01). After receiving felodipine, very low-frequency power increased (p < 0.01), whereas low- and high-frequency powers and the low- to high-frequency ratio remained unchanged. This study demonstrates that verapamil, but not felodipine, improves HRV in the early phase after AMI.
Authors:
D Bonaduce; M Petretta; A Ianniciello; C Apicella; V Cavallaro; F Marciano
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  79     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-08     Completed Date:  1997-04-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  564-9     Citation Subset:  AIM; IM    
Affiliation:
Institute of Internal Medicine, Cardiology and Heart Surgery, University of Naples Federico II, Italy.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects
Calcium Channel Blockers / administration & dosage,  therapeutic use*
Delayed-Action Preparations
Electrocardiography, Ambulatory / drug effects
Felodipine / administration & dosage,  therapeutic use*
Female
Follow-Up Studies
Forecasting
Heart Rate / drug effects*
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology
Single-Blind Method
Thrombolytic Therapy
Time Factors
Treatment Outcome
Verapamil / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Delayed-Action Preparations; 52-53-9/Verapamil; 72509-76-3/Felodipine

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


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