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Title: Improved exercise myocardial perfusion during lidoflazine therapy

Abstract

Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a study of 6 patients with severe classic angina pectoris, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise.

Authors:
; ;
Publication Date:
Research Org.:
Cardiovascular Section, Veterans Administration Medical, Torrence, California
OSTI Identifier:
5128509
Resource Type:
Journal Article
Resource Relation:
Journal Name: Angiology; (United States); Journal Volume: 34:11
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MYOCARDIUM; SCINTISCANNING; PIPERAZINES; HEALTH HAZARDS; BIOLOGICAL STRESS; DYNAMIC FUNCTION STUDIES; EXERCISE; MEMBRANE TRANSPORT; PATIENTS; PERFUSED TISSUES; THALLIUM 201; ANIMAL TISSUES; AZINES; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; ELECTRON CAPTURE RADIOISOTOPES; HAZARDS; HEART; HEAVY NUCLEI; HETEROCYCLIC COMPOUNDS; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; ORGANS; PYRAZINES; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; TISSUES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Shapiro, W., Narahara, K.A., and Park, J. Improved exercise myocardial perfusion during lidoflazine therapy. United States: N. p., 1983. Web. doi:10.1177/000331978303401103.
Shapiro, W., Narahara, K.A., & Park, J. Improved exercise myocardial perfusion during lidoflazine therapy. United States. doi:10.1177/000331978303401103.
Shapiro, W., Narahara, K.A., and Park, J. 1983. "Improved exercise myocardial perfusion during lidoflazine therapy". United States. doi:10.1177/000331978303401103.
@article{osti_5128509,
title = {Improved exercise myocardial perfusion during lidoflazine therapy},
author = {Shapiro, W. and Narahara, K.A. and Park, J.},
abstractNote = {Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a study of 6 patients with severe classic angina pectoris, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise.},
doi = {10.1177/000331978303401103},
journal = {Angiology; (United States)},
number = ,
volume = 34:11,
place = {United States},
year = 1983,
month =
}
  • Thallium-201 myocardial perfusion scintigraphy is reported to be a less accurate diagnostic test for coronary artery disease in women than in men. We retrospectively analyzed 34 Tl-201 studies obtained in 28 symptomatic women and compared them with those obtained in 32 men during the same interval. Three criteria were tested: criterion 1 was defined as abnormal scans showing any defect; criterion 2, scans showing only transient (reversible) defects; and criterion 3, scans showing either transient or significant (i.e., not due to breast attenuation) fixed defects. The sensitivity in women was 1.00, 0.73, and 0.93, respectively; the specificity, 0.26, 0.84, andmore » 0.85. The best values in men were a sensitivity of 1.00 and a specificity of 0.86. The three criteria were then prospectively tested in 33 scans of 29 additional women. The sensitivity was 0.90, 0.65, and 0.80, respectively, and the specificity, 0.18, 1.00, and 0.92. Defects (usually fixed) due to breast attenuation artifact were seen frequently (30%). Criterion 3 best differentiates such defects from those resulting from coronary artery disease, making Tl-201 myocardial perfusion scintigraphy as accurate in women as in men.« less
  • Practical and noninvasive means are needed for evaluating efficacy of coronary bypass surgery (CBS) in improving blood flow (CBF) to ischemic myocardium in coronary patients. Revascularization was assessed in 15 patients by pre- and post-CBS rest and exercise rubidium-81 myocardial images with a scintillation camera equipped with pinhole collimator and high-energy shield. Ischemic areas were detected by decreased /sup 81/Rb activity after exercise compared to rest. Before CBS all patients had exercise angina (EA), positive treadmill ECG (TECG), and abnormal exercise /sup 81/Rb scans. After CBS all 15 patients had increased physical activity before angina or completion of treadmill exercisemore » with increased heart rate-blood pressure product (HRBP) (+63 +/- 3.2 x 10(2) bpm - mm Hg) in 14 of 15 patients indicating increased CBF; four had positive TECG, and five had EA. The increased HRBP in 14 patients was associated with improved post-CBS exercise /sup 81/Rb scans: six had normal patterns while nine were improved with less ischemic patterns. Further, lack of angina and increased exercise tolerance correlated closely with increased /sup 81/Rb myocardial perfusion. Thus pre- and postoperative rest and exercise /sup 81/Rb scintigraphy gives an accurate, noninvasive, objective approach for evaluation of CBF following CBS and demonstrates the usefulness of this revascularization procedure in coronary patients.« less
  • The maximal exercise capacity of cardiac transplant recipients is reduced compared with that of normal subjects. To determine if this reduced exercise capacity is related to inadequate myocardial perfusion during exercise, myocardial perfusion was measured noninvasively with use of positron emission tomography and nitrogen (N)-13 ammonia. Twelve transplant recipients with no angiographic evidence of accelerated coronary atherosclerosis were studied. Serial N-13 ammonia imaging was performed at rest and during supine bicycle exercise. The results were compared with those from 10 normal volunteers with a low probability of having cardiac disease. A two-compartment kinetic model for estimating myocardial perfusion was appliedmore » to the data. Transplant recipients achieved a significant lower exercise work load than did the volunteers (42 {plus minus} 16 vs. 128 {plus minus} 22 W), but a higher venous lactate concentration (31.3 {plus minus} 14.9 vs. 13.7 {plus minus} 4.1 mg/100 ml). Despite the difference in exercise work load, there was no significant difference in the cardiac work achieved by transplant recipients and normal subjects as evidenced by similar rate-pressure products of 24,000 {plus minus} 3,400 versus 21,300 {plus minus} 2,800 betas/min per mm Hg, respectively. In addition, myocardial blood flow during exercise was not significantly different between the two groups (1.70 {plus minus} 0.60 vs. 1.56 {plus minus} 0.71 ml/min per g, respectively). This study demonstrates that the myocardial flow response to the physiologic stress of exercise is appropriate in transplant recipients and does not appear to explain the decreased exercise capacity in these patients.« less
  • Seven men ranging in age from 35 to 63 years with a chest pain syndrome and cineangiographically documented systolic narrowing of the left anterior descending coronary artery underwent thallium-201 myocardial scintigraphy and gated cardiac blood pool imaging. Grade II (50 to 75 percent) systolic coronary arterial constriction was present in three patients and grade III constriction (greater than 75 percent) in four. Three of the four patients with grade III constriction had an exercise-induced perfusion abnormality in the thallium-201 scintigram and impaired left ventricular ejection fraction response during exercise. (In two patients the left ventricular ejection fraction did not changemore » and in one patient it decreased.) Each of the three patients with grade II constriction had normal thallium-201 perfusion and a normal increase in ejection fraction during exercise. These data provide evidence of abnormal myocardial perfusion and impaired left ventricular function during exercise in patients with high grade systolic coronary arterial narrowing.« less
  • We studied the effect of intravenous isosorbide dinitrate (ISDN) on myocardial perfusion of patients with coronary artery disease, by using exercise thallium-201 (TI-201) myocardial scintigraphy. A control study was conducted initially to assess regional myocardial perfusion rate. Left ventricular myocardium was divided into six parts: anterior, lateral, apical, inferior, posterior, and septal segments. The segmental myocardial perfusion was characterized according to TI-201 initial uptake index (IUI) of relative distribution and redistribution index (RDI) of TI-201 washout. The normal limit of IUI and RDI was established from the data of 17 persons with normal coronary arteries, and then the IUI lessmore » than or equal to 84% and the RDI greater than or equal to 1.12 was defined as abnormal. Based on IUI and RDI, each segment was characterized into three types: A type = IUI less than or equal to 84%, RDI greater than or equal to 1.12; B type = IUI less than or equal to 84%, RDI less than 1.12; and C type = IUI greater than 84%, RDI less than 1.12. ISDN was given as a dose of 0.1 mg/kg/hr, and then treadmill testing was repeated for the same duration of exercise time using the same protocol as in the control period. The segments of A type showed a significant improvement in IUI and RDI after receiving ISDN infusion, while the B and C type segments showed no change. It was also shown that the improvement of IUI and RDI of the A type segments was not as marked in multivessel disease as in cases of single-vessel disease.« less