EFFECT OF NICARDIPINE ON EFFORT TOLERANCE IN MICROVASCULAR ANGINA

尼卡地平对微血管心绞痛努力耐受力的影响

• 批准号: 3899260
• 负责人: R CANNON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3899260
• 关键词: angina pectoris; angiography; calcium channel blockers; cardiovascular stress test; drug tolerance; human subject; human therapy evaluation; microcirculation; nicardipine; oxygen consumption

A subset of patients with angina pectoris despite angiographically normal coronary arteries have limited coronary flow reserve as a consequence of dysfunctional small coronary arteries, a syndrome we have called microvascular angina (MVA). Although calcium channel blockers are useful therapy in the majority of MVA patients, approximately 1/3 continue to have angina. Eighteen MVA patients symptomatic despite trials of commercially available calcium channel blockers participated in a drug trial using a new dihydropyridine derivative, nicardipine. Compared to baseline study off all medications, MVA patients demonstrated approximately one minute improvement in exercise duration and two minute prolongation of time to onset of angina during treadmill exercise testing using the Bruce protocol on nicardipine 30 mg three times daily for three weeks, without any change in myocardial oxygen consumption at peak exercise or peak expiratory flow rate. Sixteen patients subsequently participated in a randomized, double blind study of nicardipine 30 mg three times daily and identical appearing placebo, each for one month. Two patients developed generalized macular rashes on nicardipine and were withdrawn from this phase of the study. The remaining fourteen patients demonstrated no significant differences in treadmill exercise duration and myocardial oxygen consumption or symptom end-point between nicardipine and placebo phases. Thus nicardipine was of demonstrable benefit to only a minority of MVA patients who were symptomatic failures on conventional calcium channel blockers.

尽管血管造影正常但仍患有心绞痛的患者亚组 冠状动脉具有有限的冠状动脉血流储备， 小冠状动脉功能失调，我们称之为 微血管性心绞痛（MVA）。虽然钙通道阻滞剂是有用的 在大多数MVA患者中，大约1/3的患者继续接受治疗， 心绞痛18名MVA患者尽管进行了市售药物试验， 现有的钙通道阻滞剂参与了一项药物试验， 二氢吡啶衍生物，尼卡地平。与基线研究相比， 在药物治疗中，MVA患者表现出大约一分钟的改善， 运动持续时间和心绞痛发作时间延长2分钟 在使用尼卡地平的布鲁斯方案的踏车运动试验期间 30 mg，每日三次，持续三周，心肌无任何变化 运动峰值或呼气流速峰值时的耗氧量。十六 患者随后参加了一项随机、双盲研究， 尼卡地平30 mg，每日3次，安慰剂外观相同， 一个月。两名患者出现全身性黄斑皮疹， 尼卡地平，并退出该研究阶段。其余 14名患者在跑步机上没有显着差异 运动持续时间和心肌耗氧量或症状终点 在尼卡地平和安慰剂阶段之间。因此，尼卡地平 仅对少数MVA患者有明显获益， 常规钙通道阻滞剂治疗失败的症状。