Noninvasive techniques in clinical pharmacology. Time intervals in assessment of vasodilators in coronary artery disease.
We enrolled 15 male volunteers with angiographic evidence of coronary artery disease (CAD) to investigate the effects of sublingual administration, on different days, at random, of placebo and three drugs with different action such as isosorbide dinitrate, nifedipine and molsidomine. We recorded simultaneously electrocardiogram, phonocardiogram and carotid pulse at paper speed of 100 mm/s; blood pressure was measured by auscultatory method. We calculated the systolic time intervals (STI) being noninvasive indices of left ventricular function and the ratio of diastolic time to heart rate (%D), well related to coronary blood flow in patients with severe obstructive lesions. Placebo decreased heart rate (HR) without effects on STI or %D. Isosorbide dinitrate induced a prolonged pre-ejection period (PEP) (by decreasing preload), tachycardia and a significantly decreased %D, suggesting a fall in coronary blood flow time. Nifedipine decreased diastolic blood pressure and values of PEP (by decreasing afterload) without effects on %D. Finally, molsidomine prolonged PEP (by decreasing preload) without reflex induced tachycardia and changes of %D. In conclusion, mechanocardiography can be useful in noninvasive assessment of vasodilators in CAD patients.
Romano
M
M
Ferro
G
G
Carella
G
G
Ricciardelli
B
B
Chiariello
M
M
Condorelli
M
M
D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D003971:Diastole / Q000187:drug effects; D004562:Electrocardiography; D006334:Heart Function Tests / Q000379:methods*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010701:Phonocardiography; D011674:Pulse; D013599:Systole / Q000187:drug effects; D013997:Time Factors; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents