Pharmacological effects on coronary haemodynamics. A comparative study between atenolol, verapamil, nifedipine and carbocromen

Simonsen, S.

Acta Medica Scandinavica. Supplementum 645: 97-104


ISSN/ISBN: 0365-463X
PMID: 6940429
Accession: 006097380

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Effects on coronary hemodynamics were investigated in patients with ischemic heart disease. Investigations were performed at rest and during a cardiac stress test provoked by atrial pacing to submaximal heart rates. The effects of 4 drugs used in the treatment of angina pectoris were studied. The continuous infusion thermodilution method was used to measure left ventricular venous drainage. CFV at rest, but had no effect during atrial pacing. The decrement in flow and O2 consumption effected by the drug could be attributed solely to a reduction in heart rate and therefore in left ventricular work. No direct effect on coronary arteriolar resistance could be identified. Injection (verapamil) and sublingual (infedipine) application of Ca antagonists gave a weak coronary vasodilatory effect at rest, but not during cardiac stress. No O2 saving effect was demonstrated as M.ovrhdot.VO2 and M.ovrhdot.VO2 per unit left ventricular work was unaffected by the drugs. Neither was there any effect on the major general hemodynamic determinants of O2 demand. Carbocromen was a potent coronary vasodilator at rest and during atrial pacing. This did not result in any change in M.ovrhdot.VO2 as there was a parallel decrease in coronary arteriovenous O2 difference. Investigations performed during angina pectoris demonstrated metabolic evidence of increased ischemia after carbocromen which may be due to a coronary steal effect. Interventions may influence left ventricular O2 consumption favorably. No effect or untoward effects are exerted by substances which are in use today in patients with coronary heart disease.