Nicorandil infusion leads to good recovery from ischemia of left ventricular regional work in comparison with nitroglycerin.
Nicorandil is an antianginal drug that exerts both a conventional nitrate effect and an independent ATP-dependent potassium channel-opening effect. The present study examined the effects of nicorandil on left ventricular regional work (RW) during coronary angioplasty in 22 patients with angina pectoris who were scheduled for angioplasty to the left anterior descending artery. The patients were randomly assigned to receive either nitroglycerin (group NG, n=12, 0.5 microg x kg(-1) min(-1)) or nicorandil (group NR, n = 10, 1.5 microg x kg(-1) min(-1)). Inflation was performed for 60 s and the data were collected every 10 s. The RW was derived from the relation between mean wall stress and area strain. The RW of the interventricular septum decreased after balloon inflation and was at its minimum after the 60s inflation (group NR: 1.24 +/- 0.72mJ/cm3, group NG: 0.63 +/- 0.25mJ/cm3). After balloon deflation, the septal RW of both groups increased, and recovered to the baseline condition at about 30s. At 20 s after deflation, the septal RW in group NR (3.58 +/- 1.17 mJ/cm3) was significantly higher than that in group NG (2.25 +/- 0.59mJ/cm3) (p < 0.05). An intravenous infusion of nicorandil led to good recovery of RW from ischemia compared with that obtained with nitroglycerin.
Isobe
Naoki
N
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. isobe.n@cvc.pref.gunma.jp
Oshima
Shigeru
S
Taniguchi
Koichi
K
Hoshizaki
Hiroshi
H
Adachi
Hitoshi
H
Toyama
Takuji
T
Naito
Shigeto
S
Nogami
Akihiko
A
Sugawara
Motoaki
M
D000368:Aged; D000787:Angina Pectoris / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000494:pharmacology; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D020108:Nicorandil / Q000008:administration & dosage* / Q000494:pharmacology; D005996:Nitroglycerin / Q000008:administration & dosage / Q000494:pharmacology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D020108:Nicorandil; D005996:Nitroglycerin