| The effect of an angiotensin-converting enzyme inhibitor and a K+(ATP) channel opener on warm up angina. | |
| | |
MedLine Citation:
|
PMID: 15618027 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIMS: In various models, angiotensin-converting enzyme (ACE) inhibitors and K+(ATP) channel openers can potentiate and mimic ischaemic preconditioning, respectively. Our aim was to determine whether these characteristics are shared by the phenomenon of warm up in angina, often regarded as a surrogate of ischaemic preconditioning. METHODS AND RESULTS: Twenty patients with ischaemic heart disease were assigned in a double blind, randomized cross-over design to equivalent pressor doses of nicorandil 20 mg bid, enalapril 10 mg bid, losartan 25 mg bid, or placebo for 3 days. Patients underwent three consecutive exercise tolerance tests on each medication separated by a 1-week interval. Each patient underwent 12 exercise tests in total and 13 patients completed the study. On each medication the second exercise was separated from the first by 15 min of rest and the third exercise was performed 90 min after the second to control for training. The time to 0.1 mV ST depression and rate pressure product at 0.1 mV ST depression increased significantly in all groups during exercise two compared with exercise one. Nicorandil reduced angina but did not attenuate this warm up effect. This benefit of first exercise waned by test three with placebo, losartan, and nicorandil, but not with enalapril. CONCLUSION: In contrast to predictions based on ischaemic preconditioning the magnitude of the warm up was apparently unaltered by nicorandil, losartan, or enalapril, however its duration seemed to be extended by enalapril. Thus ischaemic preconditioning and warm up angina are likely to have differing pharmacological profiles suggesting a diverse underlying mechanism. |
| | |
Authors:
|
Richard J Edwards; Simon R Redwood; Pier D Lambiase; Michael S Marber |
Related Documents
:
|
2978997 - Efficacy of the calcium antagonist isradipine in angina pectoris. 408007 - Exercise testing and indirect assessment of myocardial oxygen consumption in evaluation... 1587067 - Exercise alters the pharmacokinetics of midazolam. 6811177 - An objective comparison of verapamil and placebo in chronic stable angina. 2606857 - Increased total concentration of na-k pumps in vastus lateralis muscle of old trained h... 8396707 - Effect of sodium bicarbonate ingestion on exhaustive resistance exercise performance. |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2004-12-20 |
Journal Detail:
|
Title: European heart journal Volume: 26 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2005 Mar |
Date Detail:
|
Created Date: 2005-03-01 Completed Date: 2005-06-16 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
|
Languages: eng Pagination: 598-606 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, KCL, The Rayne Institute, St Thomas' Hospital, London SE1 7EH, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adaptation, Physiological Angina Pectoris / etiology Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Cross-Over Studies Double-Blind Method Electrocardiography Enalapril / therapeutic use* Exercise Test Female Humans Ischemic Preconditioning, Myocardial Losartan / therapeutic use Male Middle Aged Myocardial Ischemia / drug therapy*, physiopathology Nicorandil / therapeutic use* Potassium Channels / drug effects* Receptors, Angiotensin / antagonists & inhibitors Regression Analysis Vasodilator Agents / therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin-Converting Enzyme Inhibitors; 0/Potassium Channels; 0/Receptors, Angiotensin; 0/Vasodilator Agents; 114798-26-4/Losartan; 65141-46-0/Nicorandil; 75847-73-3/Enalapril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography,...
Next Document: The Cardiology Audit and Registration Data Standards (CARDS), European data standards for clinical c...