title: Effects of diltiazem and long-term beta 1-adrenergic blockade on hemodynamics and blood flow during exercise in patients with stable angina pectoris.
abstract: The short-term effects of oral diltiazem on hemodynamics and distribution of cardiac output at rest and during semiupright bicycle exercise were evaluated in eight patients with stable effort angina on long-term beta 1-adrenergic blockade. Cardiac output and iliofemoral blood flow were measured using thermodilution. The patients were exercised to the same work load on a bicycle before and 2 h after oral diltiazem (60 mg in two patients and 120 mg in six). At maximal exercise, diltiazem reduced heart rate from 94 +/- 5 to 88 +/- 6 beats/min (p less than 0.01), mean arterial pressure from 139 +/- 5 to 127 +/- 4 mm Hg (p less than 0.01) and systemic vascular resistance from 9.7 +/- 0.7 to 8.4 +/- 0.4 x 10(2) dynes.s.cm-5 (p less than 0.05) compared with control. During exercise, cardiac output, iliofemoral blood flow, mean pulmonary wedge pressure and mean right atrial pressure were not altered, but stroke volume increased from 119 +/- 11 to 131 +/- 10 ml (p less than 0.05). Maximal ST segment depression during exercise was decreased and angina was less. Diltiazem does not alter the distribution of the cardiac output during exercise but improves ischemia.
authors.affiliation: Hallstrom Institute of Cardiology, University of Sydney, Royal Prince Alfred Hospital, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Ogasawara
authors.forename: S B
authors.initials: SB
authors.lastname: Freedman
authors.forename: J
authors.initials: J
authors.lastname: Ram
authors.forename: D T
authors.initials: DT
authors.lastname: Kelly
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000188:drug therapy*; D001262:Atenolol / Q000627:therapeutic use; D002302:Cardiac Output / Q000187:drug effects*; D004110:Diltiazem / Q000627:therapeutic use*; D015444:Exercise / Q000502:physiology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D012039:Regional Blood Flow / Q000187:drug effects; D013997:Time Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D001262:Atenolol; D004110:Diltiazem; D008790:Metoprolol