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European Heart Journal 1990 11(5):454-461;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Effects of the calcium antagonist, isradipine, and nifedipine on resting and exercise haemodynamics and the neurohumoral system in patients with stable chronic angina

V. MlTROVIC1, C. RlECKMANN, P. KORNECKI, K. J. BURGER, D. WELZEL and M. SCHLEPPER

Kerckhoff-Klinik of the Max Planck Society BadNauheim, F.R.G.

Received 31 July 1989; revised 4 October 1989; .

1Address correspondence to: Dr. V. mitrovic. Kerckhoff-Klinik, Benekestrasse 2–8. D-6350 Bad Nauheim. F.R.G.

Abstract

In a randomizeddouble-blindstudy, the haemodynamic and anti-ischaemic effects of the new dihydropyridine calcium channel blocker isradipine (5 mg and 10 mg thrice daily (t.i.d.) ) were investigated over 1 week in nine patients with coronary artery disease and chronic effort angina and compared with nifedipine (20 mg t.i.d.) and placebo.

In standardized exercise stress tests and exercise radionuclide ventriculography, haemodynamics improved under medication compared with placebo: resting end-diastolic and end-systolic volume index decreased on isradipine 5 mg, 10 mg and on nifedipine, and ejection fraction at rest increased with all medications. Resting mean arterial pressure was reduced compared with placebo accompanied by a decrease in systemic vascular resistance (P<0–05) and systolic wall tension (P<0.05).

Cumulative ST-segment depression was significantly reduced by all three medications ( –48%, –23%, –36%), while the increase in work capacity was insignificant. No significant change was found for either heart rate, double product, cardiac index, or stroke work index. Resting plasma levels of nor adrenaline, adrenaline and renin activity increased with all three medications (except adrenaline at isradipine 5 mg).

Isradipine has favourable effects comparable with those of nifedipine in patients with chronic stable angina and can be safely administered in these patients.

Key Words: Isradipine • nifedipine • exercise ECG • Tc-99m-ventriculography


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