Improved left ventricular performance during exercise with verapamil or nifedipine in patients with chronic stable angina (original) (raw)
1987, American Heart Journal
ov exercige with v6br with chronic st To examine the effects of chronic oral therapy with verapamii, 120 mg three times a day, and nifedipine, 20 mg four times daiiy, on left ventricular ejection fraction and regional wail motion at rest and exercise, 10 patients with chronic stable angina pectoris underwent serial rest and exercise radionuctide angiography. Pre drug control study reveaied a resting left ventricular ejection fraction (LVEF) of 0.62 ? 0.08, faiiing to 0.54 + 0.12 at peak exercise (p < 0.05). Wail motion score deteriorated from a resting vatue of 13.8-t 2.3 to 10.8 + 1.8 (p < 0.01) with exercise. Patients were subsequently randomized to verapamii or nifediptne for 4 weeks each in an open-labeled crossover design. Rest and exercise radionuciide angtography were repeated at the end of each 4-week period. Neither verspamii nor nifedtpine had a significant effect on resting LVEF (verapamii LVEF = 0.81 + 0.10, nifedipine LVEF = 0.84 f 0.02). Likewise, they had no significant effect on resting wail motion score (verapamii = 14.2-+ 2.2, nifedipine = 14.4 f 1.8). Both verapamii and nifedipine signpicantiy increased LVEF at peak exercise (verapamii = 0.63 + 0.09, nifedipine = 0.65 + 0.08, p < 0.05 vs pre drug control) and improved peak exercise wail motion score (verapamii = 13 ? 1.9, nifedipine = 13.8 f 1.6, p < 0.05 vs pre drug control). Both drugs significantly reduced maximal ST depression at peak exercise and prolonged exercise duration. Episodes of angina and nitroglycerin use were also significantly reduced. in summary, verapamii and nifedipine improved left ventricular performance at exercise in patients with angina pectoris. (AM HEART J 1987; 113:700.
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