Document Detail

Role of endogenous opioids on nociceptive threshold in patients with exercise-induced myocardial ischemia.
MedLine Citation:
PMID:  1913714     Owner:  NLM     Status:  MEDLINE    
To evaluate whether endogenous opioids (EO) play a role in the perception of anginal pain, a randomized double blind clinical trial, using naloxone (N) and placebo (P) and measuring beta-endorphin (beta-ep) plasma levels, was performed. We studied 10 patients with angiographically assessed coronary artery disease (CAD) and stable exercise-induced myocardial ischemia (established by 2 preliminary bicycle ergometric tests) of whom 5 symptomatic (SYM) and 5 asymptomatic (ASYM) and 5 subjects without CAD as a control group (CON). On a third exercise test the beta-ep plasma level (fmol/ml) was measured at rest (SYM 5.4 +/- 2.3 vs ASYM 7.2 +/- 2.3 vs CON 6.8 +/- 2.6, NS), at peak exercise (SYM 4.4 +/- 1.8 vs ASYM 8.0 +/- 4.2 and vs CON 6.2 +/- 2.7, NS) and during recovery (SYM 7.5 +/- 4.2 vs ASYM 7.2 +/- 3.0 vs CON 6.7 +/- 2.5, NS). On 2 subsequent tests patients received N (0.2 mg/kg) or P intravenously and chest pain was evaluated on an analogue scale (score from 1 to 10). After N compared to P we observed: an increased perception of chest pain in SYM (6.8 +/- 1.5 vs 4.2 +/- 1.0; p less than 0.01) without significant changes of the ischemic threshold (total work, heart rate-blood pressure product, ST segment changes, 2D-echocardiographic wall motion abnormalities); no modifications in ASYM and CON.(ABSTRACT TRUNCATED AT 250 WORDS)
F Fedele; G Benedetti; C D Vizza; L Agati; M Penco; C Barletta; D Scavo; A Dagianti
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiologia (Rome, Italy)     Volume:  36     ISSN:  0393-1978     ISO Abbreviation:  Cardiologia     Publication Date:  1991 Mar 
Date Detail:
Created Date:  1991-11-13     Completed Date:  1991-11-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8506637     Medline TA:  Cardiologia     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  207-11     Citation Subset:  IM    
Fisiopatologia Cardiovascolare, Università degli Studi, L'Aquila, Roma.
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MeSH Terms
Coronary Disease / physiopathology*
Double-Blind Method
Exercise Test
Middle Aged
Naloxone / diagnostic use
Pain Measurement*
beta-Endorphin / blood,  physiology*
Reg. No./Substance:
465-65-6/Naloxone; 60617-12-1/beta-Endorphin

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

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