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Microperfusion in coronary artery disease under treatment with the calcium antagonist gallopamil
H Eichstädt1, O Danne, M Gutmann
1Department of Cardiology, University Hospital Berlin, Charlottenburg, West Germany.
Insights
Gallopamil, a calcium channel blocker, improves myocardial perfusion in patients with coronary issues. This study confirms its effectiveness in enhancing blood flow to the heart muscle, offering a potential alternative to bypass surgery.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Calcium channel blockers are crucial in modern coronary therapy.
- Gallopamil inhibits calcium influx into heart and smooth muscle cells.
- It increases myocardial perfusion, serving as an adjunct therapy or alternative to bypass grafting.
Purpose of the Study:
- To objectively evaluate clinical improvement after gallopamil therapy using reliable methods.
- To assess the impact of gallopamil on myocardial perfusion.
- To provide reproducible measurements of gallopamil's therapeutic effects.
Main Methods:
- 31 patients underwent longitudinal tomoscintigraphy before and after gallopamil treatment.
- Treatment involved intravenous and oral administration of gallopamil.
- Computerized circumferential mapping of impulse rates was used for analysis.
- A placebo control phase followed oral therapy.
Main Results:
- Gallopamil therapy significantly increased impulse density in ischemic myocardial segments.
- Both intravenous and oral administration demonstrated positive effects on perfusion.
- Objective measurements confirmed clinical improvement post-therapy.
Conclusions:
- Gallopamil effectively enhances myocardial perfusion.
- The drug demonstrates significant therapeutic benefits in patients with coronary conditions.
- Objective data supports gallopamil's role in coronary therapy and as a potential alternative to surgical interventions.
Abstract:
The calcium antagonistic principle, i.e. the inhibition of calcium influx into the heart muscle cell and smooth muscle cell, in this particular case gallopamil as an example of a drug with this principle of action, can certainly be regarded as one of the most important concepts in modern coronary therapy. On account of the increase of myocardial perfusion, which is ascribed to this calcium antagonist, gallopamil may be administered as an adjunct to postoperative therapy. It is even a drug alternative to bypass grafting. Previous investigations of the ST segment and subjective ischemic parameters have not always shown coherent findings. The purpose of this study was to objectify clinical improvement after therapy with gallopamil (Procorum) by means of reliable methods and reproducible measurements. Myocardial perfusion was analysed in 31 patients by longitudinal tomoscintigraphy before and after therapy with 2 x 2 mg gallopamil intravenously and 6 weeks at 3 x 50 mg/d orally followed by placebo control. The computerized circumferential mapping of impulse rates showed a significant increase of impulse density in ischemic segments after both intravenous and oral therapy with gallopamil.