Hemodynamic, Antiischemic, and Neurohumoral Effects of Tedisamil and Atenolol in Patients with Coronary Artery Disease

摘要: Clinical drawbacks of beta-blocker treatment in stable angina have motivated researchers to provide alternative heart-rate-lowering agents, such as tedisamil, which additionally exerts antiischemic and antiarrhythmic effects by blockade cellular repolarizing K+ currents. Forty-eight patients with pectoris were investigated (doubleblind, randomized, parallel grouped) comparing the hemodynamic, antiischemic, metabolic neurohumoral tedisamil 100 mg b.i.d. atenolol 50 after a single dose over 6 days treatment. Tedisamil produced decrease heart rate both at rest [day 1:-13.6 versus −15.4 bpm; day 6: −14.8 −22.2 bpm, resp.; p > 0.05] exercise 1; −9.1 −18.3 = 0.001; 6; −12.0 −24.8 0.001], while anginal threshold increased. Cardiac output decreased 1: −1.01 −1.19 l/min; 0.05; −0.86 −1.10 l/min, −0.82 −1.28 −0.65 −2.68 0.03], stroke volume remained unchanged. Right atrial pressure changed during only: it (−1.7 mmHg) increased (+3.7 (p < .001). Mean pulmonary capillary wedge pressures (−0.5 (−6.9 group but tended increase on [rest: +1.7; exercise: +3.7 0.03). Arterial under only. Exercise-induced plasma norepinephrine levels reduced (−93 pg/ml) elevated (+172 0.001). As compared atenolol, prolongation QTc interval [+31 8 ms] initial values 0.408 ± 0.018 s PQ QRS remaining unaltered. In angina, (100 b.i.d.) (50 generated similar effects. The efficacy measured ST segment depression threshold, was comparable that atenolol.