| Dynamic stress echocardiography for evaluating anti-ischemic drug profiles in post-MI patients. | |
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MedLine Citation:
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PMID: 9415850 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise ECG is an established method of evaluating the anti-ischemic properties of drugs. However, there are considerable methodologic limitations to this procedure and its use is restricted to patients with exercise-provoked ECG alterations which can be interpreted as ischemia. The principal, earlier onset of wall motion abnormalities according to the ischemic cascade can be detected by stress echocardiography and might be utilized as a pharmacological stress testing modality. Sixteen consecutive patients (15 men, one woman; 53 +/- 9 years old) with angiographically proven coronary artery disease (8 with one-, 5 with two-, and 3 with three-vessel disease) and exercise-induced wall motion abnormalities were examined by dynamic stress echocardiography (50 watt followed by 20-watt increases/min). Anti-ischemic drugs were withdrawn prior to and on day 1; on the following day 2, 0.2 microgram/kg/min nisoldipine was infused intravenously during the test after a 3 micrograms/kg bolus was given. At maximum comparable workload 15/16 patients showed an improved wall motion score on treatment (day 1: 22.9 +/- 4.9 vs day 2: 20.0 +/- 3.9; normal score: 12; one-sided binomial test: p = 0.0003). Eight of 16 patients demonstrated ST-segment deviations on day 1 and day 2. The double product did not differ at any workload stage until the maximum of 130 watt (day 1: 14,101 +/- 3140 vs day 2: 13,365 +/- 2865; n.s.). Dynamic stress echocardiography seems to be a valuable tool in pharmacologic stress testing and in terms of accuracy is supposed to be superior to conventional exercise ECG. Nisoldipine reduces exercise-induced wall motion abnormalities in patients with and without exercise-induced ECG alterations. The data result from a controlled pilot study, and further studies are required to confirm these promising methodological and therapeutic findings. |
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Authors:
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U Nixdorff; R Erbel; S Wagner; T Buck; H Mertes; S Mohr-Kahaly; J Meyer |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of cardiac imaging Volume: 13 ISSN: 0167-9899 ISO Abbreviation: Int J Card Imaging Publication Date: 1997 Dec |
Date Detail:
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Created Date: 1998-02-20 Completed Date: 1998-02-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8600426 Medline TA: Int J Card Imaging Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 485-91 Citation Subset: IM |
Affiliation:
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II. Medical Clinic, Johannes Gutenberg-University, Mainz, Germany. nixdorff@2-med.klinik.uni-mainz.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Calcium Channel Blockers / therapeutic use* Exercise Test* Female Humans Male Middle Aged Myocardial Infarction / drug therapy*, ultrasonography* Nisoldipine / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 63675-72-9/Nisoldipine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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