EFFECT OF LIDOFLAZINE ON EXERCISE TOLERANCE IN MICROVASCULAR ANGINA

许多患有X综合征的患者(尽管胸痛， 冠状动脉造影术正常)有心肌 冠脉血流储备有限引起的缺血(微血管 心绞痛)。尽管大多数患者对 钙通道阻滞剂和硝酸盐，约25% 由于胸痛，继续受到明显的限制。在这 研究中，我们评估了血液动力学和症状疗效。 利多氟嗪，一种阻止钙进入冠状动脉的药物 慢通道以外部位的血管平滑肌( 钙通道阻滞剂的活性部位)。为了调查 利多氟嗪(240-360 mg/d)对运动耐量和运动耐量的影响 血流动力学，21例微血管心绞痛患者， 尽管之前使用钙通道治疗，但仍有症状 阻滞剂，接受了分级运动跑步机测试 用药，3-4周后，服用利多氟嗪。与.相比 基线，利多拉嗪导致总持续时间增加32% 运动量(p<0.005)，发病时间增加66% 胸痛(P<0.005)。更高的收缩压血的趋势 血压-心率乘积(心肌氧含量的指标 需求)可表明冠脉血流量和氧气的改善 服用利多氟嗪的许多患者在运动应激时分娩。

Many patients with Syndrome X (chest pain despite angiographically normal coronary arteries) have myocardial ischemia due to limited coronary flow reserve (microvascular angina). Although most patients respond symptomatically to calcium channel blockers and nitrates, approximately 25% continue to be significantly limited because of chest pain. In this study, we assessed the hemodynamic and symptomatic efficacy of lidoflazine, a drug that blocks calcium entry into coronary vascular smooth muscle at sites other than the slow channel (the site of activity by calcium channel blockers). To investigate the effect of lidoflazine (240-360 mg/d) on exercise tolerance and hemodynamics, 21 patients with microvascular angina, symptomatic despite prior treatment with calcium channel blockers, underwent graded exercise treadmill testing off all medication, and 3-4 weeks later, on lidoflazine. Compared to baseline, lidoflazine resulted in a 32% increase in total duration of exercise (p less than .005), and 66% increase in time to onset of chest pain (P less than .005). A trend toward higher systolic blood pressure - heart rate product (an index of myocardial oxygen demand) may indicate improved coronary blood flow and oxygen delivery during exercise stress in many patients on lidoflazine.