Bepridil improves left ventricular performance in patients with angina pectoris

Area of Science:

• Cardiology
• Pharmacology
• Cardiovascular Physiology

Background:

• Patients with coronary artery disease and angina pectoris often exhibit impaired left ventricular (LV) diastolic function, even at rest.
• These diastolic abnormalities are thought to stem from disruptions in intracellular calcium metabolism.

Purpose of the Study:

• To evaluate the efficacy of bepridil hydrochloride as monotherapy for chronic exertional angina.
• To assess the impact of bepridil on LV systolic and diastolic performance in these patients.

Main Methods:

• A placebo-controlled, randomized, cross-over trial involving 23 patients with chronic exertional angina.
• Assessment of angina frequency, nitroglycerin consumption, and treadmill exercise capacity.
• First-pass radionuclide cineangiography to evaluate LV performance at rest and during exercise.

Main Results:

• Bepridil significantly reduced weekly angina episodes (8.5 to 4.4) and nitroglycerin consumption (7.2 to 3.6 tablets).
• Treadmill exercise capacity, time to angina onset, and time to ST depression increased significantly with bepridil.
• Bepridil improved LV systolic function (increased cardiac output, stroke volume, ejection fraction) and diastolic function (increased peak ejection/filling rates, decreased filling times).

Conclusions:

• Bepridil hydrochloride is an effective monotherapy for managing exertional angina.
• Treatment with bepridil leads to enhanced exercise tolerance, reduced angina symptoms, and improved LV systolic and diastolic function.