Cardiovascular Drugs and Therapy

, Volume 4, Supplement 5, pp 909–914 | Cite as

Intravenous nifedipine prevents ergonovine-induced myocardial ischemia in patients with stable effort angina

  • Claudio Brunelli
  • Paolo Spallarossa
  • Giorgio Ghigliotti
  • Michelangelo Caudullo
  • Mario Iannetti
  • Salvatore Caponnetto
Nifedipine, Cardioprotection, and Ischemic Heart Disease
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Summary

Twelve of 40 consecutive patients with effort angina, documented coronary artery disease, and a positive exercise stress test had a positive ergonovine test. ST-segment depression (0.1 mV) occurred in ten and ST elevation (0.1 mV) in two patients. During the ergonovine maleate test the rate-pressure product recorded at the onset of ischemia (ST≥0.1 mV) was significantly lower than that recorded during the exercise stress test. The reproducibility of the rate-pressure product at ischemia was displayed in every patients with a second test; then, a third test after intravenous nifedipine infusion (1 mg over 5 minutes+1 mg over 55 minutes) was performed. Six patients had negative results; out of the remaining six, three exhibited a significant increase in the dosage required for provoking ischemia. Both systolic and diastolic blood pressure were reduced by nifedipine, while only a slight increase in heart rate occurred, so that the rate-pressure product at any ergonovine dosage was decreased by nifedipine. No differences in the ischemic threshold during exercise and during the ergonovine maleate tests (in washout and after nifedipine) were found in patients with a positive or negative response to nifedipine. The ergonovine test was positive in a sizable (30%) number of patients with stable effort angina. In these patients nifedipine was effective in preventing ergonovine-induced myocardial ischemia.

Key Words

intravenous nifedipine ergonovine test effort angina myocardial ischemia coronary vasomotion 

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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Claudio Brunelli
    • 1
  • Paolo Spallarossa
    • 1
  • Giorgio Ghigliotti
    • 1
  • Michelangelo Caudullo
    • 1
  • Mario Iannetti
    • 1
  • Salvatore Caponnetto
    • 1
  1. 1.Department of CardiologyUniversity of GenovaGenovaItaly

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