Document Detail


Improvement of exercise-induced ischaemia and myocardial perfusion after aminophylline.
MedLine Citation:
PMID:  8773436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have suggested that aminophylline improves exercise-induced ischaemia by preventing the redistribution of the coronary flow from ischaemic to non-ischaemic myocardium. The purpose of the study was to assess whether aminophylline improves myocardial perfusion in zones supplied by collateral circulation. METHODS: Twenty-three patients with an occluded coronary artery and collateral circulation from a non-diseased vessel underwent two symptom-limited exercise 99mTc-MIBI, single-photon emission computed tomography (SPECT) myocardial scintigraphy experiments, which were preceded by an intravenous infusion of either aminophylline (5 mg/kg over 20 min) or saline solution in a randomized double-blind control procedure. The MIBI SPECT images were analysed by two experienced observers who were blinded to each other's data. RESULTS: All patients underwent cardiac catheterization. For 16 patients this was because of stable angina and the remaining eight were post-myocardial infarction patients with a positive exercise test. Aminophylline significantly increased the time to the onset of ischaemia in the 15 patients with a positive exercise test (mean +/- SD, 6.5 +/- 1.9 compared with 5.3 +/- 1.8 min, P < 0.005); and ischaemia occurred at higher rate-pressure product (230 +/- 68 compared with 195 +/- 68 HB x mmHg, P < 0.03). After aminophylline, exercise ST-segment depression was 1.1 +/- 0.5 mV, compared with 1.5 +/- 0.8 mV after placebo (P < 0.01). All patients had perfusion defects that resolved partially or completely in the rest images. The imaging score was significantly lower after aminophylline infusion than after placebo (9.7 +/- 9 compared with 12.1 +/- 10, P < 0.01). CONCLUSIONS: Aminophylline significantly delayed the time to onset of exercise-induced ischaemia and improved perfusion in zones supplied by collateral circulation. Aminophylline-like drugs may be useful in the treatment of selected patients with ischaemic heart disease.
Authors:
E Roig; J Magriñá; M Paz; P Bassa; L Recasens; M Huguet; M Heras; G Sanz
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Coronary artery disease     Volume:  7     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-11-15     Completed Date:  1996-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  69-73     Citation Subset:  IM    
Affiliation:
Cardiology Unit Hospital Clinic, University of Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aminophylline / administration & dosage*
Angina Pectoris / drug therapy*,  physiopathology,  radionuclide imaging
Collateral Circulation / drug effects,  physiology
Coronary Circulation / drug effects,  physiology
Coronary Disease / drug therapy*,  physiopathology,  radionuclide imaging
Double-Blind Method
Exercise Test / drug effects*
Female
Heart Catheterization
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology,  radionuclide imaging
Phosphodiesterase Inhibitors / administration & dosage*
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 109581-73-9/Technetium Tc 99m Sestamibi; 317-34-0/Aminophylline

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


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