Short- and long-term effects of nisoldipine on cardiac function and exercise tolerance in patients with hypertrophic cardiomyopathy

Tokushima, Takashi; Utsunomiya, Toshinori; Ogawa, Taiji; Kidoh, K.; Ohtsubo, Yoshihiko; Ryu, Toshihiro; Yoshida, Kazuyo; Ogata, Toru; Tsuji, Shinsuke; Matsuo, Shuzo

doi:10.1007/bf00789305

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…Mibefradil treatment for 4–6 weeks reduced IRT without any effect on the E/A ratio. A similar effect has been reported for the dihydropyridine calcium antagonist nisoldipine in subjects with a recent myocardial infarct [11]as well as in patients with hypertrophic cardiomyopathy [10]. …”

Section: Discussionsupporting

confidence: 54%

“…Both beta-blockers and calcium antagonists have been shown to affect the diastolic function of the left ventricle [7, 8, 9, 10, 11, 12, 13, 18, 19, 20], but studies directly comparing this effect of these two drug types are sparse. The present study is the first study directly comparing the effect of a beta-blocker and a calcium antagonist on the diastolic function of the left ventricle in patients with ischemic heart disease.…”

Section: Discussionmentioning

confidence: 99%

“…Calcium antagonists and beta-blockers are often used for symptomatic treatment of angina pectoris in patients with ischemic heart disease. Improvement of various measures of diastolic function has been demonstrated during treatment with these drugs in patients with hypertension [7, 8], dilated [9]or hypertrophic [10]cardiomyopathy, and ischemic heart disease [11, 12], but randomized double-blind studies comparing the effect of calcium antagonists and beta-blockers on diastolic function are lacking. One recent study comparing the effect of the calcium antagonist mibefradil and the beta-blocker atenolol on regression of left ventricular hypertrophy in hypertensive patients noted that the E/A ratio (a Doppler echocardiography measure of diastolic function) increased equally in both groups [13].…”

Section: Introductionmentioning

confidence: 99%

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Different Effects of Calcium Antagonist and Beta-Blocker Therapy on Left-Ventricular Diastolic Function in Ischemic Heart Disease

et al. 2001

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Objective: To compare the effect of a calcium antagonist and a beta-blocker on left-ventricular diastolic function in patients with ischemic heart disease. Methods: 138 patients with chronic stable angina pectoris were randomized in a multicenter, double-blind trial to treatment with either mibefradil or atenolol for 6 weeks (50 mg once daily for 2 weeks followed by 100 mg once daily for 4 weeks). The ratio between early (E) and late (A) diastolic mitral flow velocities (E/A), the E wave deceleration time (DT) and the left ventricular isovolumetric relaxation time (IRT) were measured by Doppler echocardiography as parameters of left-ventricular diastolic function initially, after 4 and after 6 weeks of treatment. Results: Mibefradil did not change the E/A ratio significantly (+4%, NS), while atenolol treatment resulted in a significant increase in the E/A ratio (+20%, p < 0.001). Mibefradil treatment, on the other hand, resulted in a significant decrease (–8%, p < 0.001) in IRT, while atenolol treatment did not change IRT. Neither mibefradil nor atenolol treatment changed DT significantly. Conclusions: Both mibefradil and atenolol treatment significantly improves echocardiographic indices of left-ventricular diastolic function in patients with chronic stable angina. However, they affect different parameters and thus apparently act through different mechanisms.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Different Effects of Calcium Antagonist and Beta-Blocker Therapy on Left-Ventricular Diastolic Function in Ischemic Heart Disease

et al. 2001

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“…or oral administration of calcium channel blockers. 57,58 These drugs appear to improve the intracellular calcium overload of the myocardium in addition to reducing afterload. These effects have been reported in patients with arterial hypertension with or without LV hypertrophy.…”

Section: Treatmentmentioning

confidence: 99%

Left Ventricular Diastolic Function in the Elderly

Tokushima

Reid

Gardin

2001

American J Geri Cardiology

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Previous studies using pulsed Doppler echocardiography have demonstrated a pattern of abnormal left ventricular relaxation associated with increasing age. Specifically, aging is associated with decreased peak velocity of early diastolic mitral inflow, increased peak velocity of late diastolic inflow, increased isovolumic relaxation time, and early diastolic deceleration time. Abnormal relaxation can progress to significantly elevated left atrial pressure--characterized by increased early peak velocity and shortened isovolumic relaxation time and deceleration time--as part of the disease processes. Left ventricular diastolic dysfunction is highly prevalent, occurring in one half to two thirds of elderly patients with congestive heart failure, in association with normal systolic function. Left ventricular hypertrophy, which is commonly related to systemic arterial hypertension, and ischemic heart disease are the two major causes of abnormal left ventricular diastolic function in the elderly. Recently, newer echocardiographic techniques have been described that allow more accurate evaluation of left ventricular diastolic function. Treatments for left ventricular diastolic dysfunction should focus on the underlying disease etiology as well as on the derangement in left ventricular diastolic function. Although calcium channel blockers and angiotensin-converting enzyme inhibitors have been used clinically to treat diastolic dysfunction, their effects on prognosis remain unproven.

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“…Second and third generation 1,4-DHPs are available to treat hypertension, angina, hypertrophic cardiomyopaty [56], pulmonary hypertension, Raynaud's phenomenon [57] and post-hemorrhagic cerebral vasospasm [58].…”

Section: Selectivity Of 14-dhp In Ltcc Isoformsmentioning

confidence: 99%

1,4-Dihydropyridine Scaffold in Medicinal Chemistry, The Story so Far And Perspectives (Part 1): Action in Ion Channels and GPCRs

Ioan¹,

Carosati²,

Micucci³

et al. 2011

CMC

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Since the pioneering studies of Fleckenstein and co-workers, L-Type Calcium Channel (LTCC) blockers have attracted large interest due to their effectiveness in treating several cardiovascular diseases. Medicinal chemists achieved high potency and tissue selectivity by decorating the 1-4-DHP nucleus, the most studied scaffold among LTCC blockers. Nowadays it is clear that the 1,4-DHP nucleus is a privileged scaffold since, when appropriately substituted, it can selectively modulate diverse receptors, channels and enzymes. Therefore, the 1,4-DHP scaffold could be used to treat various diseases by a single-ligand multi-target approach. In this review, we describe the structure-activity relationships of 1,4-DHPs at ion channels, G-protein coupled receptors, and outline the potential for future therapeutic applications.

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Short- and long-term effects of nisoldipine on cardiac function and exercise tolerance in patients with hypertrophic cardiomyopathy

Cited by 7 publications

References 13 publications

Different Effects of Calcium Antagonist and Beta-Blocker Therapy on Left-Ventricular Diastolic Function in Ischemic Heart Disease

Different Effects of Calcium Antagonist and Beta-Blocker Therapy on Left-Ventricular Diastolic Function in Ischemic Heart Disease

Left Ventricular Diastolic Function in the Elderly

1,4-Dihydropyridine Scaffold in Medicinal Chemistry, The Story so Far And Perspectives (Part 1): Action in Ion Channels and GPCRs

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