| Coronary vasomotion during dynamic exercise: influence of intravenous and intracoronary nicardipine. | |
MedLine Citation:
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PMID: 7642851 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Our aim was to evaluate the influence of a calcium channel blocking agent of the dihydropyridine group (nicardipine) on coronary vasomotion during dynamic exercise. BACKGROUND: Coronary vasomotion plays an important role in the pathophysiology of myocardial ischemia. METHODS: Twenty-nine patients with coronary artery disease were studied at rest and during bicycle exercise with the use of biplane quantitative coronary angiography. Twelve patients without pretreatment (group 1) served as control subjects. Seventeen patients (group 2) received nicardipine, either 0.2 mg by intracoronary injection (n = 9) or 2.5 mg intravenously (n = 8) before exercise. RESULTS: In the control group there was exercise-induced vasoconstriction (-29%, p < 0.001) of the stenotic segment but coronary vasodilation (+22%, p < 0.05) of the normal vessel segment. In group 2, nicardipine induced coronary vasodilation of both the normal (+16%, p < 0.001) and the stenotic vessel segment (+35%). During subsequent exercise there was some additional vasodilation of normal (+4%, p = NS) and stenotic arteries (+5%, p = NS). There was no difference between either intracoronary or intravenous nicardipine with regard to vasodilation. Application of sublingual nitroglycerin was associated with significant vasodilation of the normal vessel segment in groups 1 (+18%, p < 0.05) and 2 (+15%, p < 0.001). The stenotic vessels showed a significant increase in percent cross-sectional area after nitroglycerin in groups 1 (+12%, p = NS) and 2 (+51%, p < 0.001). Exertional angina pectoris occurred less frequently in group 2 (18%) than in group 1 (67% [p < 0.005 vs. group 2]); group 2 also had a smaller increase in mean pulmonary artery pressure (+14 vs. +21 mm Hg, p < 0.05). CONCLUSIONS: Exercise induces vasoconstriction of stenotic, but vasodilation of normal, coronary vessel segments. Intravenous and intracoronary nicardipine prevent vasoconstriction of stenotic coronary arteries during exercise and exert a significant anti-ischemic effect. The combination of two anti-ischemic drugs, nitroglycerin and nicardipine, has an additive effect on coronary vasomotion that is seen only in the stenotic vessel segment. Thus, the anti-ischemic action of nicardipine is mainly due to a primary effect on coronary vasomotor response rather than to secondary effects such as changes in loading conditions. |
Authors:
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P Kaufmann; G Vassalli; U Utzinger; O M Hess |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 26 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1995 Sep |
Date Detail:
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Created Date: 1995-09-20 Completed Date: 1995-09-20 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 624-31 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, University Hospital, Zurich, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Coronary Angiography / drug effects, instrumentation, methods, statistics & numerical data Coronary Disease / diagnosis, drug therapy, physiopathology Coronary Vessels / drug effects*, physiopathology Exercise / physiology* Exercise Test / drug effects, methods, statistics & numerical data Female Heart Catheterization Humans Infusions, Intra-Arterial Infusions, Intravenous Male Middle Aged Nicardipine / administration & dosage, pharmacology* Vasoconstriction / drug effects* Vasodilation / drug effects* |
| Chemical | |
Reg. No./Substance:
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55985-32-5/Nicardipine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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