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Nicorandil Improves Left Ventricular Myocardial Strain in Patients With Coronary Chronic Total Occlusion

Shaomin Chen1, Chen Ma2,3, Xinheng Feng1

  • 1Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China.

Frontiers in Cardiovascular Medicine
|June 1, 2022
PubMed

Insights

Nicorandil improved left ventricular global area strain and angina symptoms in patients with chronic total occlusion (CTO). This study provides evidence for nicorandil

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Stable angina management often involves second-line treatments like nicorandil.
  • Limited randomized-controlled trials exist for nicorandil's efficacy in chronic total occlusion (CTO).

Purpose of the Study:

  • To assess nicorandil's effect on left ventricular (LV) myocardial strain in CTO patients.
  • To evaluate improvements in angina symptoms using the Seattle Angina Questionnaire (SAQ).

Main Methods:

  • A randomized controlled trial involving 61 patients with CTO, divided into nicorandil and control groups.
  • Nicorandil (15 mg/day) was administered for 3 months.
  • Three-dimensional speckle-tracking echocardiography and SAQ surveys were used for assessment.

Main Results:

  • The nicorandil group showed significantly improved LV global area strain (GAS) compared to the control group (-23.7 ± 6.3% vs. -20.3 ± 5.6%, p=0.033).
  • Significant improvements were observed in SAQ scores for angina stability, frequency, and treatment satisfaction in the nicorandil group.
  • No significant differences were found in other LV strain parameters, ejection fraction, or volumes between groups.

Conclusions:

  • Nicorandil treatment effectively enhances LV global area strain in patients with CTO.
  • Nicorandil also improves subjective angina symptoms and treatment satisfaction in this patient population.
Abstract

Keywords:
chronic total occluscoronary heart diseaseglobal area strainnicorandilspeckle tracking echocardiograph

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