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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The comparative efficacy and safety of oxyfedrine and propranolol in the management of angina pectoris was evaluated in a double-blind randomized cross-over study. Out of 21 patients registered, 14 completed the study. Three patients dropped out due to poor response and 4 were lost to follow up. Both the drugs i.e. oxyfedrine (8-24 mg three times a day) and propranolol (40-80 mg three times a day) produced a significant reduction in the incidence of anginal attacks and the consumption of nitroglycerine tablets. Propranolol produced a better response than oxyfedrine although the difference was not significant. This may be due to the small sample size. No change in heart rate and rate-pressure product was observed with oxyfedrine, in contrast to that seen with propranolol. The beneficial effect of treatment on exercise tolerance and ST-segment depression was more marked with propranolol. No significant change in laboratory parameters was observed with either drug.
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PMID:Double-blind crossover clinical trial of oxyfedrine and propranolol in angina pectoris. 388 57

Ten patients with chronic effort angina and coronary artery disease (luminal diameter reduction greater than 75%) were stressed by atrial pacing (140 beats/minutes) before and 15 minutes after intravenous propranolol (mean dose 7.4 mg). Myocardial substrate exchange of oxygen, blood lactate, plasma free fatty acids, citrate, glucose, glutamate, and alanine as well as coronary sinus blood flow were measured. Coronary sinus blood flow, oxygen consumption, and systemic haemodynamics did not change after propranolol. Propranolol did not influence arterial lactate concentration, and it reduced the arterial concentration of free fatty acid by 37% and increased that of glutamate by 21%. During pacing myocardial lactate extraction increased in all 10 patients; in two lactate release was converted to lactate uptake. Propranolol reduced free fatty acid uptake and increased glutamate uptake during pacing. For both substances the changes in aortocoronary sinus differences or in uptake or both correlated positively with the changes in their delivery to the heart from extracardial sources (arterial concentrations/loads). In the unstressed state before pacing, aortocoronary sinus lactate differences correlated inversely with free fatty acid differences and positively with those of glutamate. During pacing the relation between lactate and glutamate differences remained positive while the inverse correlation between lactate and free fatty acid differences was lost. Myocardial citrate release was halved during pacing and recovery. Propranolol did not influence alanine or glucose exchanges. An improved myocardial lactate extraction after propranolol administration may be secondary to decreased free fatty acid uptake or increased glutamate uptake or both. In the unstressed state both mechanisms may be of importance. During pacing induced ischaemia, increased glutamate uptake is more likely than reduced free fatty acid uptake to be the mechanism responsible for the improvement in myocardial lactate extraction. The propranolol mediated alterations in myocardial substrate exchanges may reflect the extracardial effects of the drug.
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PMID:Improved myocardial lactate extraction after propranolol in coronary artery disease: effected by peripheral glutamate and free fatty acid metabolism. 394 48

A precise and sensitive high-performance liquid chromatographic method using a column packed with porous polystyrene gel is described for the determination of propranolol in plasma and plasma water from normal subjects and patients with angina pectoris. Propranolol in the samples was extracted with an n-heptane-isoamylalcohol (98.5:1.5) mixture after addition of penbutolol used as an internal standard. The extracts were chromatographed and detected with a spectrofluorophotometer. The quantitative limit of propranolol was 1 ng using 1 ml of plasma or 0.5 ml of plasma water. The present method should be useful for monitoring propranolol concentrations in plasma and plasma water during drug therapy and for pharmacokinetic study of propranolol.
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PMID:Quantitative determination of propranolol in plasma and plasma water from normal subjects and patients with angina pectoris by high-performance liquid chromatography. 395 89

Because the combined use of a beta-adrenergic blocking agent and a calcium antagonist may be beneficial in some patients with severe angina, the acute hemodynamic and electrophysiologic effects of intravenous propranolol in the presence and absence of oral diltiazem treatment was studied. In 22 patients (11 men, 11 women, mean age 50 years), 12 receiving diltiazem (mean 243 mg/day, range 180 to 360) and 10 not receiving diltiazem, hemodynamic and electrophysiologic variables were measured before and 5 minutes after intravenous propranolol (0.1 mg/kg). Cardiac index (by thermodilution) and left ventricular (LV) peak dP/dt fell and LV end-diastolic pressure increased similarly in both groups. Mean systemic arterial pressure was unchanged. Coronary sinus blood flow (by thermodilution) decreased slightly in patients receiving diltiazem and was unchanged in those not receiving it. Propranolol caused a similar reduction in heart rate and increase in atrio-His conduction in both groups. Thus, when intravenous propranolol is given to patients with normal or only mildly depressed LV systolic function, the hemodynamic and electrophysiologic effects are similar in those receiving and not receiving oral diltiazem.
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PMID:Acute hemodynamic and electrophysiologic effects of propranolol in patients receiving diltiazem. 401 39

Effects of isosorbide 5-mononitrate (5-ISMN) on cardiovascular function were compared with those of isosorbide dinitrate (ISDN), verapamil and propranolol. In anesthetized open-chest dogs, intravenous injection of 5-ISMN (1 mg/kg, 3 mg/kg) scarcely decreased cardiac contractile force (CCF) and heart rate (HR). The systolic blood pressure (SBP) fell in a dose-dependent manner, and the degree of the change was greater than that in diastolic blood pressure (DBP). Especially, left ventricular pressure (LVP) and left ventricular dp/dt (LVdp/dt) were significantly decreased, and a considerable reduction in left ventricular end-diastolic pressure (LVEDP) was also observed. Intravenous injection of verapamil (0.3 mg/kg) considerably lowered DBP. While HR, CCF, LVP and LVdp/dt were markedly decreased, LVEDP showed a moderate increase. Propranolol (0.5 mg/kg, i.v.) greatly decreased LVdp/dt together with HR and CCF. Conversely, LVEDP showed a slight increase. There was no change in SBP, DBP and LVP. The vasodilating potency of 5-ISMN was 150 times smaller than that of ISDN on the contractile response in isolated rabbit thoracic aorta. On the other hand, in terms of decrease in pulse pressure, the potency exhibited by 5-ISMN was about 4 times (intravenous administration in anesthetized dogs) or 1.5 times (oral administration in conscious dogs) smaller than that of ISDN. The present results suggest that 5-ISMN shows a high bioavailability and a potency comparable to ISDN, especially in the case of peroral administration. Taking these results together with the fact that transient left ventricular failure occurs during myocardial ischemia into consideration, it is thought that peroral 5-ISMN preparation may be useful in the therapy of angina pectoris.
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PMID:[Effects of isosorbide 5-mononitrate on cardiovascular function. (I). Effects on the left ventricular system]. 402 5

In a controlled double-blind study practolol, a new cardioselective beta-blocking drug, was given to 15 patients with angina pectoris, and compared with propranolol 80 mg. q.d.s. The dose of practolol ranged from 200 to 600 mg.b.d. and was decided by initial open titration in individual patients. Though practolol did not influence the incidence of angina or glyceryl trinitrate consumption, it increased the duration of exercise possible in exercise tests and reduced the amount of ischaemic S-T depression in the radiocardiogram during exercise. Propranolol reduced the incidence of angina and, in the exercise tests, increased the amount and duration of exercise but did not affect the degree of S-T depression. Unlike propranolol, practolol did not produce any adverse effects on bronchial smooth muscle. Hence it is concluded that practolol is an effective drug in treating angina, and in the dosage used is of potential value in patients with asthmatic bronchitis and angina. It should, however, be used cautiously in anginal patients with heart failure.
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PMID:Clinical evaluation of practolol, a new cardioselective beta-blocking agent in angina pectoris. 439 83

In the treatment of angina pectoris a double-blind evaluation of verapamil (Cordilox) at two dose levels-namely, 80 mg thrice daily and 120 mg thrice daily-propranolol (Inderal) 100 mg thrice daily, and isosorbide dinitrate (Vascardin) 20 mg thrice daily has been made against a placebo. The assessment was based on relief from daily attacks of angina on effort and the response to a whole-body exercise test. We can find no statistically significant difference between the effects of verapamil (120 mg three times a day) and propranolol (100 mg three times a day) in the treatment of angina of effort. Both of these preparations are more effective than a placebo both in the reduction of daily attacks (P < 0.01) and in the prolongation of exercise test (P < 0.05). Isosorbide dinitrate (20 mg three times a day) appears to be no more effective than a placebo in the treatment of angina on effort, but 14 out of 32 patients experienced headache of such severity that even when the dose was reduced to 10 mg thrice daily this drug therapy had to be withdrawn. Both propranolol (100 mg three times a day) and verapamil (120 mg three times a day) had a significant lowering effect on the diastolic blood pressure as measured with the patient standing (P < 0.01).
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PMID:Double-blind evaluation of verapamil, propranolol, and isosorbide dinitrate against a placebo in the treatment of angina pectoris. 457 Jun 71

Traditionally when considering the pharmacologic basis of therapy in angina pectoris, attention is focussed on alterations of coronary blood flow. Yet the diseased coronary arteries in these patients often do not appear to be capable of responding to vasodilatory drugs. Since the pain of myocardial ischemia is relieved by a number of interventions without an increase in coronary blood flow, the concept herein considered is that angina pector is best viewed as an unfavorable relation between myocardial oxygen requirements and availability. Thus, the clinical value of the major antianginal agents is thought to be based importantly upon their actions to reduce myocardial oxygen consumption rather than to increase coronary blood flow. Sublingual nitroglycerin possesses a powerful dilator effect on veins which reduces venous return and thereby the size of the heart and intra-myocardial tension; thus myocardial oxygen requirements are diminished. The beta-adrenergic receptor blocking drug, propranolol (Inderal(R)), inhibits sympathetic stimulation of the heart at rest and during exercise. Thus, myocardial oxygen requirements are diminished by the reduction in heart rate and diminished contractility. As a result of this latter action, cardiac output is reduced and thereby arterial pressure and intramyocardial tension is lowered. In patients with advanced heart disease and borderline cardiac compensation, propranolol is hazardous because it removes the availability of one of the important reserve mechanisms for maintaining cardiac compensation-the sympathetic support of the failing heart. The introduction of electrical stimulation of the carotid sinus nerves as a means of therapy in patients with angina pectoris has provided a powerful tool for the treatment of patients with refractory ischemic pain.
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PMID:New trends in the treatment of angina pectoris. 498 Aug 81

1. The cardiac actions of amiodarone, a benzofuran derivative used in the treatment of angina pectoris, have been compared with those of (+/-)-propranolol in anaesthetized dogs.2. After three successive intravenous injections of propranolol, 0.5 mg/kg, had reduced the heart rate by 25%, a fourth dose had no further negative chronotropic action, but amiodarone, 10 mg/kg intravenously, at this point reduced the heart rate by 23%.3. Amiodarone, 10 mg/kg intravenously, reduced, but did not abolish, cardiac responses to isoprenaline, 2 mug/kg intravenously. Subsequent successive injections of 10 mg/kg of amiodarone did not further block the responses to isoprenaline, but propranolol, 1 mg/kg intravenously, abolished them.4. Amiodarone reduced cardiac chronotropic and inotropic responses to glucagon, which were not affected by propranolol.5. Cardiac output was increased 5 min after amiodarone, 10 mg/kg intravenously, but at 10 min and thereafter it did not differ from control values. Propranolol, 1 mg/kg intravenously, reduced cardiac output by 17% at 5 min, and by 30% after 30 min.6. From this and other evidence which is discussed, it is concluded that the cardiac actions of amiodarone are not produced by competitive blockade of beta-adrenoceptors.
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PMID:Cardiac actions in the dog of a new antagonist of adrenergic excitation which does not produce competitive blockade of adrenoceptors. 548 43

Plasma levels of cholesterol (C), triglycerides (TG), phospholipids (PL) (in total plasma, very low density [VLDL], low density (LDL), and high density [HDL] lipoproteins) and of two apolipoproteins (apo-B and apo-A) were studied in 13 hyperlipidemic patients suffering from hypertension and/or stable angina and treated by metoprolol or propranolol. Propranolol reduced the low density and high density lipoprotein phospholipids by 26% and 11%, respectively, and increased the very low density phospholipids by 24%. Metoprolol had only a transient effect on high density lipoprotein phospholipids. VLDL apolipoprotein-B was markedly increased by propranolol (67%), whereas apolipoprotein-A was slightly (8%) increased during metoprolol treatment. The reduced low density lipoprotein phospholipids and the increased high density lipoprotein apo-A correlated with the plasma concentration of propranolol and metoprolol, respectively. These results suggest that the comparative effects of beta-adrenoreceptor blocking agents on lipoprotein metabolism should be considered in their long-term use in patients with risk factors for hypertension and myocardial infarction.
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PMID:Beta blockers and their effects on lipoproteins, phospholipids, apoproteins A and B, in whole plasma and the different fractions. 612 82


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