Document Detail

Different coronary vasomotor effects of nifedipine and therapeutic correlates in angina with spontaneous and effort components versus Prinzmetal angina.
MedLine Citation:
PMID:  2916407     Owner:  NLM     Status:  MEDLINE    
Flow impedance, probably of vasomotor origin, superimposed on severe coronary stenosis has been considered a trigger for the spontaneous component of angina occurring both on effort and at rest. To investigate more thoroughly this pathophysiologic aspect we evaluated (by means of quantitative coronary angiography) the acute vasomotor reaction to nifedipine (10 mg sublingually) of significant (greater than 50%) stenotic lesions in 22 patients with double-component angina. We also correlated this reaction with the clinical response (daily number of ischemic episodes evaluated by means of 48-hour Holter ambulatory monitoring) to treatment with nifedipine (20 mg four times a day); calcium channel blockade, in fact, is considered a specific remedy in cases of altered coronary vasomotility. Patients with Prinzmetal angina, who were known to have homogeneous coronary vasodilating reactions and favorable clinical responses to nifedipine, were studied by means of the same methods and served as the control group (14 patients). In double-component angina the residual lumen diameter of significant lesions was unchanged in two patients, enhanced in 10, and reduced in 10 after sublingual nifedipine; lumen variations from baseline values ranged from +1.29 to -1.56 mm. Acute changes in stenosis correlated closely with results obtained with oral treatment. In the group with Prinzmetal angina, coronary stenoses invariably responded with dilatation (the residual coronary lumen increased by an average of 69% of baseline); 100% of the patients in this group responded favorably to treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
A Loaldi; F Fabbiocchi; P Montorsi; N De Cesare; A Bartorelli; A Polese; M D Guazzi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  117     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1989 Feb 
Date Detail:
Created Date:  1989-03-17     Completed Date:  1989-03-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  315-22     Citation Subset:  AIM; IM    
Institute of Cardiology, University of Milan, Italy.
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MeSH Terms
Angina Pectoris / drug therapy*,  physiopathology,  radiography
Angina Pectoris, Variant / drug therapy*,  physiopathology,  radiography
Coronary Angiography
Coronary Circulation / drug effects*
Heart Rate
Middle Aged
Monitoring, Physiologic
Nifedipine / therapeutic use*
Physical Exertion
Vasomotor System / drug effects*
Reg. No./Substance:

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