Document Detail


An exercise hemodynamic comparison of verapamil, diltiazem, and amlodipine in coronary artery disease.
MedLine Citation:
PMID:  2149514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective, randomized study compared the effects of equivalent intravenous doses of three slow calcium-channel blockers (verapamil, diltiazem, and amlodipine) on rest and exercise haemodynamics in 30 ischemic heart disease patients. Following a stable control period during which rest and exercise (supine bicycle) hemodynamics were assessed, equivalent hypotensive doses of each compound were administered over 20 minutes and rest/exercise parameters were assessed 10 minutes later. At rest all agents similarly reduced systemic blood pressure; the fall in systemic vascular resistance and the increase in cardiac indices was ranked: amlodipine greater than diltiazem greater than verapamil. The heart rate increase for amlodopine differed from verapamil and diltiazem (+19.4% vs. +1.5% vs. -7%; p less than 0.01). On exercise, similarly greater falls in the systemic vascular resistance index followed amlodipine, compared with verapamil and diltiazem (p less than 0.05). Only amlodipine significantly reduced the exercise pulmonary artery occlusion pressure (PAOP). Exercise cardiac stroke volume improved after diltiazem and amlodipine. In terms of cardiac performance, both amlodipine and diltiazem produced an improvement, whereas verapamil depressed cardiac pumping activity. Thus, hemodynamic differences between slow-calcium-channel blocking drugs may be demonstrated in humans. These differences would be compatible with a predominant peripheral vascular site of action for amlodipine, in contrast with mixed cardiac and peripheral sites for diltiazem and verapamil.
Authors:
B Silke; E Goldhammer; S K Sharma; S P Verma; S H Taylor
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  4     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1991-03-22     Completed Date:  1991-03-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  457-63     Citation Subset:  IM    
Affiliation:
University Department of Cardiovascular Studies, General Infirmary at Leeds, UK.
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MeSH Terms
Descriptor/Qualifier:
Amlodipine
Angina Pectoris / drug therapy,  etiology
Calcium Channel Blockers / therapeutic use*
Cardiac Output / drug effects
Coronary Disease / complications,  drug therapy*
Diltiazem / therapeutic use
Exercise / physiology*
Hemodynamics / drug effects*
Humans
Middle Aged
Nifedipine / analogs & derivatives,  therapeutic use
Prospective Studies
Rest / physiology
Verapamil / therapeutic use
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 42399-41-7/Diltiazem; 52-53-9/Verapamil; 88150-42-9/Amlodipine

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


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