The appearance of impaired left ventricular diastolic function in chronic ischemic heart disease often precedes systolic dysfunction. Myocardial ischemia and increased calcium loading have been implicated in the genesis of increased left ventricular stiffness. We have assessed the effects of long-term therapy with different classes of calcium channel-blocking drugs on left ventricular peak filling rate in patients with chronic stable angina and congestive heart failure secondary to ischemic heart disease. Therapeutic effects of nicardipine (30 mg t.i.d.), nisoldipine (10 mg b.i.d.), and verapamil (120 mg t.i.d.) (4 weeks) have been assessed on radionuclide left ventricular diastolic filling parameters in patients with chronic stable angina using placebo-controlled studies. All three drugs significantly improved exercise capacity as compared with placebo. Verapamil produced significant improvements in peak filling rate (p less than 0.005), time to peak filling rate (p less than 0.01), and first one-third filling fraction (p less than 0.005), whereas nicardipine only improved peak filling rate (p less than 0.005); neither drug altered the mean ejection fraction (n = 20). Nisoldipine did not significantly alter diastolic filling parameters or ejection fraction (n = 10). Nisoldipine and digoxin were also assessed in congestive heart failure (New York Heart Association [NYHA] classes II and III) associated with ischemic heart disease (n = 26) (open parallel design). Neither produced significant alterations in peak filling rate and ejection fraction after 3 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

In this single-blind, placebo-controlled trial, carvedilol, a nonselective beta-blocking and vasodilating agent was studied in six patients with chronic stable angina. All patients had reproducible treadmill exercise time without medical treatment and developed chest pain in association with ST-segment depression (greater than 1 mm at J + 80 msec) on exercise. None had a history of rest or unstable angina or myocardial infarction within three months prior to the study. In all patients, anti-anginal medication except sublingual nitroglycerin was discontinued for 10 days. The patients entered an initial two week-phase of placebo. They then received carvedilol, 25 mg and then 50 mg twice daily for two weeks on each dose, followed by another two week-placebo-phase. Radionuclide ventriculography was performed at the end of each phase at rest and during maximal symptom-limited exercise. Bicycle ergometry was carried out in the supine position with incremental workloads. Exercise time and workload were recorded at the end of the first phase and imaging was performed at the same time and workload throughout the trial. Carvedilol produced a dose-related reduction in rest and exercise heart rate and blood pressure. Peak exercise ST-segment change was reduced by both doses of carvedilol, but this did not achieve a level of significance. After the first placebo phase all patients had abnormal left ventricular wall motion and resting ejection fraction (range: 35% to 45%). Four out of six patients had significant improvement in wall motion abnormalities, in two patients there was no change, and none developed a deterioration in abnormal wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)

Ioversol 320, a new nonionic iodinated contrast medium, was injected intravenously into 24 healthy male volunteers using saline as a control. Physical examination, vital signs, electrocardiogram, biochemical and hematological data were recorded before and at intervals after injection. No significant changes were observed. Seventeen volunteers reported no side effects; six volunteers had mild transitory symptoms considered to be related to the contrast medium. The authors conclude that broader clinical trials can be safely conducted to determine safety and tolerability of ioversol.

The myocardial washout rate of thallium-201 was studied in 85 subjects with a less than 5% likelihood of coronary artery disease undergoing rest (group I, n = 12), dipyridamole (group II, n = 24) and exercise (group III, n = 49) stress thallium-201 scintigraphy. Subjects receiving dipyridamole were subdivided into group IIA (n = 11), who received an aminophylline injection 10 minutes after dipyridamole infusion, and group IIB (n = 13), who did not. The mean and highest washout rate values in each of 3 segments in the anterior, 45 degrees and 85 degrees left anterior oblique views were calculated. In group II the mean washout rate of thallium-201 was similar in all segments of each view and the overall mean washout rate did not differ between the 3 views studied. There was a good correlation between the mean and highest washout rate values in individual subjects (r = 0.98, p less than 0.001). The mean +/- standard deviation myocardial 4-hour washout rate of thallium-201 (anterior view) was 10 +/- 6% in group I compared with 40 +/- 14% in group IIA (p less than 0.05 vs group I), 31 +/- 13% in group IIB (p less than 0.05 vs group I) and 54 +/- 11% in group III (p less than 0.05 each vs group IIA and group IIB, respectively). There was a wide variation in mean washout rate values in group II (range 12 to 58%), and this variation was not altered by aminophylline administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly is associated with an increased cardiac morbidity and mortality, but it is not clear whether this is the result of increased incidence of hypertension and coronary heart disease or of a specific disease of heart muscle. Thirty four acromegalic patients were studied by non-invasive techniques. Seven of these patients had raised plasma concentrations of growth hormone at the time of study; three were newly diagnosed and had not received any treatment. Hypertension was present in nine (26%) but only three (9%) had electrocardiographic left ventricular hypertrophy. Echocardiography showed ventricular hypertrophy in 12 (48%) and increased left ventricular mass in 17 (68%) patients. Holter monitoring detected important ventricular arrhythmias in 14 patients. Thallium-201 scanning showed evidence for coronary heart disease in eight patients. Systolic time intervals were normal except when there was coexistent ischaemic heart disease. A comparison between 19 acromegalic patients with no other detectable cause of heart disease and 22 age matched controls showed appreciably abnormal left ventricular diastolic function in the group with acromegaly. The abnormalities shown did not correlate with left ventricular mass or wall thickness. There was no difference in diastolic function between patients with active acromegaly and those with treated acromegaly. Hypertensive acromegalic patients had worse diastolic function than hypertensive controls, suggesting that hypertension may further impair the left ventricular diastolic abnormality in acromegaly. This is the first study to find evidence of subclinical cardiac diastolic dysfunction in acromegaly and it supports the suggestion that there is a specific disease of heart muscle in acromegaly.

Conference Abstract| December 01 1988 The Effect of Surgical Revascularisation on Ventricular Function in Patients with Chronic Stable Angina EA Rodrigues; EA Rodrigues 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar ME Heber; ME Heber 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar A Lahiri; A Lahiri 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 75 (s19): 6P–7P. https://doi.org/10.1042/cs075006Pc Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation EA Rodrigues, ME Heber, A Lahiri, EB Raftery; The Effect of Surgical Revascularisation on Ventricular Function in Patients with Chronic Stable Angina. Clin Sci (Lond) 1 December 1988; 75 (s19): 6P–7P. doi: https://doi.org/10.1042/cs075006Pc Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| January 01 1987 An Objective Evaluation of Once-Daily Sustained-Release Verapamil (480 Mg) in Chronic Stable Angina EA Rodrigues; EA Rodrigues 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar P Dasgupta; P Dasgupta 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar ADB Hains; ADB Hains 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar A Lahiri; A Lahiri 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar JR Whittington; JR Whittington 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1987) 72 (s16): 88P. https://doi.org/10.1042/cs072088Pa Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation EA Rodrigues, P Dasgupta, ADB Hains, A Lahiri, JR Whittington, EB Raftery; An Objective Evaluation of Once-Daily Sustained-Release Verapamil (480 Mg) in Chronic Stable Angina. Clin Sci (Lond) 1 January 1987; 72 (s16): 88P. doi: https://doi.org/10.1042/cs072088Pa Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1987 The Biochemical Society and the Medical Research Society1987 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| December 01 1988 Effects of Combined Beta Blockade and Calcium Antagonists on Myocardial Ischaemia and Ventricular Function in Stable Angina EA Rodrigues; EA Rodrigues 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar ADB Hains; ADB Hains 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar A Lahiri; A Lahiri 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Author and article information Publisher: Portland Press Ltd Online ISSN: 1470-8736 Print ISSN: 0143-5221 © 1988 The Biochemical Society and the Medical Research Society1988 Clin Sci (Lond) (1988) 75 (s19): 4P. https://doi.org/10.1042/cs075004P Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Citation EA Rodrigues, ADB Hains, A Lahiri, EB Raftery; Effects of Combined Beta Blockade and Calcium Antagonists on Myocardial Ischaemia and Ventricular Function in Stable Angina. Clin Sci (Lond) 1 December 1988; 75 (s19): 4P. doi: https://doi.org/10.1042/cs075004P Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Twenty-two patients with stable angina were studied in a randomised double-blind, placebo-controlled crossover trial to compare the antianginal effects of nicardipine (30 mg) and verapamil (120 mg), each given three times a day. Efficacy was assessed using treadmill exercise testing and 24-hour ambulatory electrocardiographic monitoring performed after an initial 2-week placebo phase and at the end of each 4-week active treatment period. Exercise time (mean +/- standard error of mean) increased from 7.4 +/- 0.5 min on placebo to 8.4 +/- 0.7 min on nicardipine (P less than 0.05) and to 9.9 +/- 0.7 min on verapamil (P less than 0.001). Resting heart rate was decreased by verapamil (P less than 0.002) and increased by nicardipine (P less than 0.02). Exercise heart rate was increased on nicardipine (P less than 0.005) but heart rate gain was higher on verapamil (P less than 0.01). Blood pressure and peak ST segment depression were unaltered by either drug but the time to 1 mm ST segment depression increased on both drugs. Ambulatory heart rates were lower on verapamil than on nicardipine and patient subjective preference was in favour of verapamil. This study confirms that both nicardipine and verapamil improve exercise capacity, but verapamil produces a greater improvement in exercise tolerance and indices of myocardial ischaemia whilst nicardipine is associated with an increase in the number of episodes of ST segment depression on ambulatory monitoring.

Conference Abstract| December 01 1988 Is the Proportion of Silent to Symptomatic Myocardial Ischaemia Altered by Coronary Artery Bypass Surgery? EA Rodrigues; EA Rodrigues 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar H Pelling; H Pelling 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar PMM Cashman; PMM Cashman 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar A Lahiri; A Lahiri 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 75 (s19): 6P. https://doi.org/10.1042/cs075006Pa Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation EA Rodrigues, H Pelling, PMM Cashman, A Lahiri, EB Raftery; Is the Proportion of Silent to Symptomatic Myocardial Ischaemia Altered by Coronary Artery Bypass Surgery?. Clin Sci (Lond) 1 December 1988; 75 (s19): 6P. doi: https://doi.org/10.1042/cs075006Pa Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| December 01 1988 The Importance of Ambulatory Heart Rate in Spontaneously Occurring Silent Myocardial Ischaemia EA Rodrigues; EA Rodrigues 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar A Lahiri; A Lahiri 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar H Pelling; H Pelling 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 75 (s19): 6P. https://doi.org/10.1042/cs075006Pb Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation EA Rodrigues, A Lahiri, H Pelling, EB Raftery; The Importance of Ambulatory Heart Rate in Spontaneously Occurring Silent Myocardial Ischaemia. Clin Sci (Lond) 1 December 1988; 75 (s19): 6P. doi: https://doi.org/10.1042/cs075006Pb Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

A randomized, double-blind, parallel-group study design was used to compare the antianginal efficacy of bevantolol (200 to 400 mg) and atenolol (50 to 100 mg) each administrated once daily for 8 weeks in 39 patients with chronic stable angina. Assessments were made using 24-hour ambulatory monitoring and treadmill exercise testing performed 22 to 24 hours after the last dose of medication. Both groups were comparable at the end of the placebo phase. In the bevantolol group, exercise time increased from 7.9 +/- 0.7 minutes with placebo to 9.3 +/- 0.7 minutes with bevantolol (mean +/- standard error of the mean) (p less than 0.05). Time to 1 mm ST depression was unaltered. Rest and exercise heart rate decreased (p less than 0.0001 and less than 0.0005, respectively) as did exercise double product (p less than 0.0001). In the atenolol group exercise time increased from 7.1 +/- 0.7 minutes with placebo to 8.2 +/- 0.8 minutes with atenolol (p less than 0.02). Time to 1 mm ST depression increased (p less than 0.005) and rest and exercise heart rate and double product decreased (p less than 0.0001 and less than 0.05, respectively). When within-group differences between placebo and active drug were compared for bevantolol and atenolol, no significant differences were detected. Both drugs were well tolerated and reduced ambulatory heart rate throughout the 24 hours. This study confirms that both bevantolol and atenolol are effective antianginal agents. Bevantolol compares well with atenolol in the treatment of patients with chronic angina, and there was a similar response to exercise testing with the 2 drugs.

Conference Abstract| December 01 1988 The Effect of Active and Passive Changes in Posture on Autonomic Function M Heber; M Heber 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EA Rodrigues; EA Rodrigues 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar EB Raftery EB Raftery 1Cardiology Department, Northwick Park Hospital, Harrow, Middlesex Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 75 (s19): 15P. https://doi.org/10.1042/cs075015Pc Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation M Heber, EA Rodrigues, EB Raftery; The Effect of Active and Passive Changes in Posture on Autonomic Function. Clin Sci (Lond) 1 December 1988; 75 (s19): 15P. doi: https://doi.org/10.1042/cs075015Pc Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| December 01 1987 Effects of Post-Infarction Ischaemic Myocardium on Exercise Lung Thallum-201 Uptake I.M. Al-Khawaja; I.M. Al-Khawaja 1Dept of Cardiology, Northwick Park Hospital & Clinical Research Centre, Harrow, Middx. England Search for other works by this author on: This Site PubMed Google Scholar E.A. Rodrigues; E.A. Rodrigues 1Dept of Cardiology, Northwick Park Hospital & Clinical Research Centre, Harrow, Middx. England Search for other works by this author on: This Site PubMed Google Scholar M.E. Heber; M.E. Heber 1Dept of Cardiology, Northwick Park Hospital & Clinical Research Centre, Harrow, Middx. England Search for other works by this author on: This Site PubMed Google Scholar A. Lahiri; A. Lahiri 1Dept of Cardiology, Northwick Park Hospital & Clinical Research Centre, Harrow, Middx. England Search for other works by this author on: This Site PubMed Google Scholar E.B. Raftery E.B. Raftery 1Dept of Cardiology, Northwick Park Hospital & Clinical Research Centre, Harrow, Middx. England Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1987) 73 (s17): 23P. https://doi.org/10.1042/cs073023Pa Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation I.M. Al-Khawaja, E.A. Rodrigues, M.E. Heber, A. Lahiri, E.B. Raftery; Effects of Post-Infarction Ischaemic Myocardium on Exercise Lung Thallum-201 Uptake. Clin Sci (Lond) 1 December 1987; 73 (s17): 23P. doi: https://doi.org/10.1042/cs073023Pa Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1987 The Biochemical Society and the Medical Research Society1987 Article PDF first page preview Close Modal You do not currently have access to this content.

The effects of a new vasodilating beta-blocking drug, carvedilol, were studied in 20 patients with chronic stable angina using a single-blind, placebo-controlled protocol. Two doses of carvedilol, 25 mg twice daily and 50 mg twice daily, were compared with placebo using analysis of variance. The study design consisted of 2 weekly phases of initial placebo followed by carvedilol, 25 mg twice daily and then 50 mg twice daily, and a second placebo period. Supine rest and exercise radionuclide ventriculography was performed at the end of each phase. Carvedilol produced a significant dose-related reduction in rest and exercise heart rate and blood pressure (p less than 0.01 to less than 0.0001). Ejection fraction at rest increased significantly, from a mean (+/- standard error) of 53 +/- 3% with placebo to 58 +/- 3% with carvedilol, 50 mg twice daily, but no improvement was noted in ejection fraction on exercise. Relative, counts-based end-systolic and end-diastolic volumes were significantly reduced at rest (p less than 0.001). Rest peak filling rate index, first-third filling fraction and ejection rate index increased significantly with carvedilol. A dose-related change was observed with rest ejection fraction, peak filling rate index and ejection rate index. Exercise-induced ST-segment depression improved significantly with both doses of carvedilol compared with placebo. Carvedilol was well tolerated and produced significant hemodynamic improvement. This salutary effect on left ventricular function may confer advantages in long-term treatment of patients with chronic stable angina.