Electrophysiologic assessment of calcium channel blockers in transplanted hearts: An experimental study

Álvarez, Lourdes; Escudero, Cristina; Torralba, Amalia; Millán, Isabel

doi:10.1016/s0022-0736(98)90007-3

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Some related reports pointed out that calcium-channel blockers are associated with reduced aortic expansion and improved survival in AAD. [ 18 19 ] Calcium antagonists generally blocked the slow calcium channels, decreasing the influx of extracellular calcium,[ 20 ] which resulted in suppression of the sinoatrial and atrioventricular nodes,[ 21 ] vascular dilation with decreased blood pressure, and reduced cardiac contractility. Adequate blood pressure regulation and subsequent decreased pressure on the aortic wall through calcium-channel blockade may theoretically decrease risks of aortic enlargement.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

Liu

Wang

et al. 2018

Chinese Medical Journal

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Background:The prevalence, presentation, management, and prognosis of coronary heart disease differ according to sex. Greater understanding on the differences between men and women with acute aortic dissection (AAD) is needed. We aimed to investigate whether sex disparities are found in patients with AAD, and to study sex differences in complications, mortality in-hospital, and long-term.Methods:We included 884 patients enrolled in our institute between June 2002 and May 2016. Considering psychosocial factors, treatments, and the outcomes in men versus those in women with AAD, we explored the association of sex with psychosocial characteristics and mortality risk. For categorical variables, significant differences between groups were assessed with the Chi-square test or Fisher's exact test, and continuous parameters were assessed with Student's t-test. Univariate and stratified survival statistics were computed using Kaplan-Meier analysis.Results:A total of 884 patients (76.1% male, mean age 51.4 ± 11.8 years) were included in this study. There were fewer current smokers in female compared with male (17.5% vs. 67.2%, χ2 = 160.06, P < 0.05). The percentage of men who reported regular alcohol consumption was significantly higher than that in women (40.6% vs. 3.8%, χ2 = 100.18, P < 0.05). About 6.2% (55 of 884) of patients with AAD died before vascular or endovascular surgery was performed, 34.4% (304 of 884) of patients underwent surgical procedures, and 52.7% (466 of 884) and 12.8% (113 of 884) of patients received endovascular treatment and medication. Postoperative mortality similar (6.0% vs. 5.6%, respectively, χ2 = 0.03, P = 0.91) between men and women. Follow-up was completed in 653 of 829 patients (78.8%). Adjustment for age, history of coronary disease, hypertension, smoking and drinking, Type A and use of beta-blocker, angiotensin II receptor blockers, angiotensin converting enzyme (ACE) inhibitor, calcium-channel blockers and statins by multivariate logistic regression analysis suggested that age (odds ratios [ORs], 1.04; 95% confidence interval [CI], 1.01–1.07; P < 0.05), using of calcium-channel blockers (OR, 0.37; 95% CI, 0.18–0.74; P < 0.05), at discharge were independent predictors of late mortality, ACE inhibitors (OR, 1.91; 95% CI, 1.03–3.54; P = 0.04) was independent risk factor of late mortality.Conclusions:In Chinese with AAD, sex is not independently associated with long-term clinical outcomes. Age, the intake of calcium-channel blockers at discharge might help to improve long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

Liu

Wang

et al. 2018

Chinese Medical Journal

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“…We found that verapamil reduced resting rate‐pressure product while amlodipine did not. This resulted from reduction in resting heart rate by verapamil, which directly effects sinus node automaticity [16].…”

Section: Discussionmentioning

confidence: 99%

Contrasting effects of verapamil and amlodipine on cardiovascular stress responses in hypertension

Lefrandt

Heitmann

Sevre³

et al. 2001

Brit J Clinical Pharma

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Aims To compare the effects of two long-acting calcium antagonists of different types on cardiovascular stress responses in hypertension. Methods One-hundred and forty-®ve patients with mild to moderate hypertension and a mean (ts.e.mean) age of 51t0.9 years received for 8 weeks the phenylalkylamine verapamil sustained release (240 mg) and the dihydropyridine amlodipine (5 mg) in a double-blind cross-over design, both after 4 weeks of placebo. Blood pressure, heart rate and plasma noradrenaline were monitored during 3 min of sustained isometric handgrip and 2 min of cold pressor. Results Blood pressure was equally reduced by both drugs. After 3 min handgrip, systolic blood pressure, heart rate and rate-pressure product were lower with verapamil compared with amlodipine. Verapamil attenuated the increases in systolic blood pressure (25t2 vs 30t2 mmHg, difference 4.6, 95% CI (1.0, 8.1), P<0.01) and ratepressure product (3.1t0.2 vs 3.6t0.3r10 3 mmHgrbeats min x1 , difference 0.5, 95% CI (0.1, 0.9), P<0.01) during handgrip compared with amlodipine. Similar results were observed during cold pressor. Plasma noradrenaline levels were lower with verapamil compared with amlodipine at rest and after both tests, but the increases in plasma noradrenaline were not signi®cantly different. Conclusions Verapamil is more effective in reducing blood pressure and rate-pressure product responses to stress compared with amlodipine. Although plasma noradrenaline is lower with verapamil at rest and after stress, the increase during stress is not different.

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“…Nondihydropyridine CCBs such as verapamil and diltiazem can also be used in cardiac transplantation patients. Animal studies, however, have shown that these agents may have more intense electrophysiologic effects in the denervated heart 24 . In addition, due to the potential for serious drug‐drug interactions between these medications and the immunosuppressants cyclosporine, tacrolimus, and sirolimus, they are not generally recommended.…”

mentioning

confidence: 99%

“…Because the effects of β‐blockers and the nondihydropyridine CCBs verapamil and diltiazem may be potentiated in the denervated heart, their use in combination should be discouraged 24,26,27 . Their additive negative inotropic effects on the heart especially in the presence of heart block could be dangerous in the transplanted heart patient when the augmented compensatory mechanisms to maintain hemodynamic stability are impaired 3,26,27 …”

mentioning

confidence: 99%

Heart Transplantation and Altered Drug Response, Part II: Pharmacologic Management of Post‐Transplantation Complications

Boettger

Lee

Rifkin

et al. 2006

Progress Cardiovascular Nurs

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Electrophysiologic assessment of calcium channel blockers in transplanted hearts: An experimental study

Cited by 3 publications

References 23 publications

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

Contrasting effects of verapamil and amlodipine on cardiovascular stress responses in hypertension

Heart Transplantation and Altered Drug Response, Part II: Pharmacologic Management of Post‐Transplantation Complications

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