[Effect of intravenous diltiazem on stress-induced myocardial ischemia (study of hemodynamics and reproducibility of repeated studies].
To obtain data about (a) the reproducibility of repeated standardized exercise tests, under blank and placebo conditions and (b) the improvement of ischaemic symptoms and of haemodynamics after intravenous application of diltiazem (0.3 mg/kg body weight), 20 patients with angina pectoris and angiographically proven coronary heart disease were analysed in a randomized double-blind study.


RESULTS
a) A control exercise test 1 h after the first blank test showed no significant changes of the following parameters neither at rest nor during exercise: heart rate, systolic and diastolic blood pressure, double product, pulmonary capillary wedge pressure, cardiac output, peripheral vascular resistance, stroke volume, ST-segment depression, symptoms of angina pectoris, and maximal work tolerance (steady state, supine position). b) After intravenous application of diltiazem, at rest, both systolic blood pressure (-13 mm Hg, p less than 0.03); diastolic blood pressure (-10 mm Hg, p less than 0.01) and peripheral vascular resistance (-189 dyn x s x cm-5, p less than 0.02) decreased. During exercise testing, diastolic blood pressure (-9 mm Hg, p less than 0.02), pulmonary capillary wedge pressure (-13 mm Hg, p less than 0.01) and peripheral vascular resistance (-152 dyn x s x cm-5, p less than 0.02) were reduced, and angina pectoris was less severe (p less than 0.01): in comparison to placebo the onset of anginal symptoms occurred later (24 vs 49 W, p less than 0.01). Maximal exercise tolerance and maximal cardiac output were improved, and ST-segment depression was less pronounced. The study shows that haemodynamic data and ischaemic parameters are well reproducible in repeated exercise tests.(ABSTRACT TRUNCATED AT 250 WORDS)
Schnellbacher
K
K
Rehabilitationszentrum für Herz- und Kreislaufkranke, Bad Krozingen.
Hirsch
F
F
Stengele
E
E
Roskamm
H
H
D000328:Adult; D000787:Angina Pectoris / Q000188:drug therapy; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy*; D004110:Diltiazem / Q000627:therapeutic use*; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011897:Random Allocation
D004110:Diltiazem
Wirkung von Diltiazem i.v. auf die belastungsinduzierte Myokardischämie (Untersuchung zur Hämodynamik und Reproduzierbarkeit von Wiederholungsuntersuchungen).