Document Detail


Metabolic and hemodynamic effects of nicardipine during pacing-induced angina pectoris.
MedLine Citation:
PMID:  3812268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During repeat exercise testing in 10 patients with stable angina, individual optimal doses of nicardipine were determined. Hemodynamic values and cardiac metabolism were studied during 2 pacing periods carried out before and after this dose (mean 5.3 mg). Postpacing ST-segment depression diminished (1 mm) after nicardipine administration (p less than 0.05), whereas pacing time to onset of angina did not change. Nicardipine administration increased heart rate 16% (p less than 0.005) and reduced systolic (10%) and diastolic (8%) blood pressures (both p less than 0.005). Coronary blood flow increased 16% (p less than 0.05) and coronary vascular resistance decreased 24% (p less than 0.01). Myocardial oxygen consumption was unchanged despite an 11% decrease in rate-pressure product during pacing (p less than 0.02). In the control state before nicardipine administration, metabolic signs of ischemia included release of lactate across the heart in 7 patients, decreased mean free fatty acid and glutamate uptake and alanine release during pacing, together with increased glucose uptake and citrate release during recovery. After nicardipine lactate release decreased in 5 of the 7 patients, pacing no longer changed free fatty acid, glutamate and alanine uptake/release from the level at rest. During recovery glucose uptake was reduced and citrate release was unaffected. The hemodynamic data indicate that nicardipine is a systemic and coronary vasodilator, increasing oxygen supply to the ischemic myocardium. The metabolic results indicate a change in substrate utilization toward that of normal heart, suggesting improved aerobic energy supply.
Authors:
A Thomassen; J P Bagger; T T Nielsen; P Henningsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  59     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-16     Completed Date:  1987-03-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  219-24     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Alanine / metabolism
Angina Pectoris / drug therapy,  metabolism*,  physiopathology*
Blood Pressure / drug effects
Cardiac Pacing, Artificial
Citrates / metabolism
Coronary Circulation / drug effects
Fatty Acids, Nonesterified / metabolism
Female
Glucose / metabolism
Glutamates / metabolism
Heart Catheterization
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Lactates / metabolism
Male
Middle Aged
Myocardium / metabolism*
Nicardipine / pharmacology*
Oxygen Consumption / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Citrates; 0/Fatty Acids, Nonesterified; 0/Glutamates; 0/Lactates; 50-99-7/Glucose; 55985-32-5/Nicardipine; 56-41-7/Alanine

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


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