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Effects of nicardipine on chronic stable effort angina: a non-invasive assessment
M Galderisi1, A Celentano, G Mossetti
1Department of Cardioangiology, 2nd Medical School, University of Naples, Italy.
Insights
Nicardipine hydrochloride effectively treated chronic stable effort angina by reducing attacks and improving exercise tolerance. This calcium channel blocker enhanced myocardial blood flow and left ventricular function with minimal side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic stable effort angina is a condition characterized by chest pain due to myocardial ischemia during exertion.
- Effective management strategies are crucial for improving patients' quality of life and reducing cardiovascular events.
Purpose of the Study:
- To evaluate the efficacy and safety of nicardipine hydrochloride in patients with chronic stable effort angina.
- To assess the impact of nicardipine hydrochloride on anginal symptoms, exercise capacity, and cardiac function.
Main Methods:
- A 4-week, single-blind study involving 12 patients with chronic stable effort angina.
- Patients received 60 mg/day of nicardipine hydrochloride.
- Evaluations included anginal attack frequency, glyceryl trinitrate consumption, treadmill exercise testing, myocardial stress 201Tl scintillography, and echocardiography.
Main Results:
- Nicardipine hydrochloride significantly reduced anginal attacks and glyceryl trinitrate use.
- Exercise tolerance improved, indicated by increased treadmill exercise time and time to angina onset/ST-segment depression.
- Myocardial perfusion improved, left ventricular function was enhanced due to afterload reduction, and systemic vascular resistance decreased.
Conclusions:
- Nicardipine hydrochloride is an effective treatment for chronic stable effort angina.
- The drug reduces myocardial oxygen consumption and enhances coronary blood flow, leading to improved left ventricular function.
- The treatment was well-tolerated with few adverse effects.
Abstract:
The effects of 60 mg/day nicardipine hydrochloride were evaluated in a 4-week single-blind study on 12 patients with chronic stable effort angina. All patients completed the treatment with few reports of adverse effects. Nicardipine hydrochloride was effective in reducing the incidence of anginal attacks and consumption of glyceryl trinitrate. Treadmill exercise time, angina onset time and the time to 1 mm ST-segment depression were increased. The extent of ST-segment depression was reduced at maximum comparable exercise, with a reduced rate-pressure product and, at maximum exercise, with an increased rate-pressure product. Myocardial stress 201Tl scintillography was carried out in eight of the patients and showed improved washout in antero-septal, infero-apical and postero-lateral segments. Echocardiographic measures of left ventricular function were enhanced because of reduction of afterload. Systemic vascular resistance and end-systolic stress were also decreased and a significant correlation was found between the increase in ejection fraction and reduction of systolic blood pressure. It is concluded that nicardipine hydrochloride is effective in the control of stable effort angina by reducing myocardial oxygen consumption and enhancing coronary blood flow thereby improving left ventricular function.