Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of the cardioselective beta-blocker, metoprolol, were evaluated under double-blind conditions in eighteen patients with angina pectoris. During an introductory run-in period of eight weeks, a placebo was given single-blindly. Thereafter two double-blind crossover periods each of four weeks followed, either 20 mg metroprolol or placebo being given t.i.d. Metoprolol gave a significant reduction in the number of anginal attacks and in nitroglycerin consumption. The patients' subjective assessments of their daily angina pectoris symptoms also showed a significant improvement compared with the placebo. At the end of each period, a standardized exercise test was performed. In comparison with placebo, metoprolol gave a significant increase of total work performed until the appearance of 1 mm ST-segment depression and until the end of exercise. The heart rate was significantly reduced at rest and during exercise. The blood pressure was significantly reduced only during exercise. None of the patients reported any severe unwanted effects. The complaints reported were mild to moderate, and the frequency during metoprolol treatment was even lower than during placebo treatment. No signs or symptoms of cardiac failure were seen in any of these patients on any occasion. It is concluded that 20 mg metoprolol t.i.d. is of benefit in the treatment of angina pectoris but further benefit might be obtained with higher doses.
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PMID:Effects of the cardioselective beta-blocker metoprolol in angina pectoris. A subacute study with exercise tests. 0 92

Eighteen patients with angina pectoris, who had previously participated in a cross-over study with 20 mg metoprolol t.i.d. and placebo, have been included in this study. During an introductory six-month open tolerability study, all patients were treated with 50 mg metoprolol t.i.d. and during a subsequent cross-over study, the efficacy of this dose was compared with that of placebo under double-blind conditions. An exercise was performed at the end of each cross-over period. Metoprolol, in a dose of 50 mg t.i.d., gave a significant improvement compared with placebo in respect of the number of anginal attacks, nitroglycerin consumption and daily subjective assessment of the patients' anginal symptoms. Metoprolol also gave a significant increase in exercise capacity, both until the appearance of 1 mm ST segment depression and until the end of exercise. Heart rate and blood pressure were reduced both at rest and during exercise. No severe unwanted effects were observed during this study ranging over eight months, and none of the patients had any signs or symptoms of cardiac failure or pulmonary dysfunction on any occasion. Unwanted effects reported were mild to moderate, and the frequency was the same as during placebo treatment. No abnormal laboratory findings were observed and the relative heart volume was not significantly changed. Administration of 50 mg metoprolol t.i.d. seems to be of greater benefit than 20 mg metoprolol t.i.d., previously investigated in these patients.
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PMID:Effects of metoprolol in angina pectoris. A subacute study with exercise tests and a long-term tolerability study. 0

Following an initial dose response study, metoprolol, a selective beta1-receptor blocking agent, was compared with equipotent dosages of propanolol in a double blind cross-over study, including exercise tolerance tests, on fourteen patients with angina pectoris. Long term therapy with metoprolol then followed until the seventy-second week. Patients performed 8% more total work on metoprolol with 15% more work recorded up to the onset of S-T depression, in comparison with propranolol. In the long term, ther was no significant difference in work performed when the daily dosage of metoprolol was changed from a q.i.d. to a b.d. regime. Metoprolol was shown to be an effective anti-anginal compound with good tolerance and safety, with gradual improvement in underlying myocardial ischaemia during long term treatment.
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PMID:An eighteen months' study of the clinical response to metoprolol, a selective beta1-receptor blocking agent, in patients with angina pectoris. 1 May 64

Three beta1-selective beta-blocker (metoprolol, practolol and H 87/07) were compared in 29 patients with stable angina pectoris. The main pharmacological difference between the three beta-blockers was their intrinsic stimulating activity (I.S.A.), metoprolol being devoid of I.S.A., practolol having moderate I.S.A. and H 87/07 having high I.S.A. Each drug was given in randomized order and the length of each cross-over period was 2 weeks. Daily activity was measured by an automatic step-counter, and subjective symptoms and nitroglycerin consumption were registered on a diary-card. Objective data, such as ECG changes and exercise capacity, were obtained by bicycle ergometer tests performed at the end of each period. At rest, the heart rate was significantly lower on metoprolol than on practolol or H 87/07. During exercise, the heart rate was significantly higher on H 87/07 than on practolol or metoprolol. No other haemodynamic differences were found between the three beta-blockers. No differences were found between the three test periods with regard to daily activity, expressed as the number of steps walked, while on the beta-blocker with high I.S.A., H 87/07, the attack rate and nitroglycerin consumption were significantly higher than when the patients were on metoprolol and practolol. No difference was found between the three beta-blockers with regard to total work or exercise time until 1 mm of S-T segment depression. Except for one patient who experienced a severe exanthema on practolol, the three beta-blockers were equally well tolerated.
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PMID:A comparative study of three beta 1-adrenoreceptor blocking drugs with different degree of intrinsic stimulating activity (metoprolol, practolol and H 87/07) in patients with angina pectoris. 3 Mar 88

The clinical effect of the beta-adrenergic blocking drug acebutolol hydrochloride (SECTRAL) was studied in 18 patients with angina pectoris. Ambulatory 24-h ECG monitoring proved to be a useful method for assessing the efficacy of this drug in individual patients in their own daily stresses and environment. Patients were studied in the control state, after two weeks' treatment with placebo, and after two weeks' constant oral dose of the drug. It was found that acebutolol produced a significant decrease in ischemic ST segment depression in patients in whom good beta-blockade was achieved. The drug was less effective in patients in whom the heart rate response to exercise was not suppressed and in those with critical coronary artery obstructions.
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PMID:Effect of acebutolol on dynamic ischemic ECG changes: a study using ambulatory twenty-four-hour ECG monitoring. 3 90

Beta-blockers have been used in cardiology for the past 15 years in three directions: angina pectoris, cardiac arrhythmias, and hypertension. The haemodynamic effects are real: --imposed bradycardia, whether the basal rhythm be sinus or atrial fibrillation; --confirmed myocardial depression which reduces the energy needs of the myocardium; --fall in systolic pressure, the mechanism of which remains open to discussion. The theories explaining these haemodynamic effects are reviewed. The harmful effects of these substances are defined, together with the drug combinations which may avoid or counteract them.
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PMID:[Hemodynamic effects of beta blockers]. 4 34

Coronary angiography was performed during 34 angina attacks in thirty patients admitted because of recurrent angina at rest. Nineteen (seventeen with S-T segment elevation and two S-T depression) had angiograms during a spontaneous attack, eleven (nine with S-T elevation and two with S-T depression) during an attack induced by intravenous ergonovine maleate. Control coronary angiograms showed a wide range of atherosclerotic obstruction, from normal vessels to severe triple-vessel disease. During the anginal attack, all patients with S-T segment elevation had vasospasm localised to one of the major branches, often resulting in complete occlusion. Attacks with S-T segment depression were seen only in patients with double or triple vessel disease, and here the vasospasm generally affected coronary branches without causing complete occlusion. When appropriately searched for, vasospastic angina seems to be common.
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PMID:Coronary vasospasm in angina pectoris. 6 16

75 patients aged under 70 years who had survived acute myocardial infarction complicated by both significant arrhythmias and cardiac failure were followed-up for 1 year in an attempt to identify features which suggest the likelihood of late death or reinfarction. Patients were carefully instructed in the identification and importance of possible prodromal symptoms and the availability of a mobile intensivecare ambulance service and a 24 h hospital control centre. Horizontal ST-segment depression or anginal pain on an exercise test done within 6 weeks of infarction was a useful predictor of late death. Routine twice weekly E.C.G. recordings taken by telephone transmitter at rest and after mild exertion resulted in the identification of significant arrhythmias in only 7 patients. 13 patients (17%) died, 5 of them instantaneously. 4 of the 13 patients and 22 of the 62 survivors reported "prodromal symptoms". Unreported prodromal symptoms were elicited retrospectively in 14 of the 62 survivors and from the relatives of 4 of the 13 patients who died. Thus, 35% of prodromal symptoms were not reported despite intensive patient education and counselling. The incidence of "prodromal symptoms" was no higher in patients who died than in those who did not die.
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PMID:Predictors of reinfarction and sudden death in a high-risk group of acute myocardial infarction survivors. 8 97

We have seen a case with spasm of the right coronary artery coming on during exercise ergometry in the course of a coronary arteriogram. The patient had angina pectoris spontaneously and on exercise. Bicycle ergometry was repeated four times by the same method, and was positive in three; in two of these there was angina and ST elevation in II, III, aVF, and ST depression in I, aVL and V2 to V5. On one occasion the test was negative, the patient having taken a trinitrin tablet one hour before the test. Repeating the exercise test during coronary arteriography showed spasm of the right coronary artery and elevation of the segment ST in II, III and aVF; this disappeared after trinitrin treatment.
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PMID:[Coronary spasm on exercise. Demonstration of a case by coronary angiography]. 10 83

Coronary haemodynamic and metabolic effects of propranolol and glyceryl trinitrate were studied in 12 patients with coronary artery disease and 5 without coronary heart disease, at rest and during tachycardia stress. Propranolol-associated reductions in indices of myocardial oxygen demand, left ventricle work, tension time, and left ventricle oxygen utilisation (LVVO2) were reversed when heart rate was controlled by atrial pacing. Adding glyceryl trinitrate at rest also restored heart rate but decreased the left ventricular work index and tension time index as coronary resistance declined paradoxically. Tachycardia-related increases in tension time index and LVVO2 were unchanged after propranolol, and ischaemia (angina, ST depression, and reduced lactate extraction) was not altered in most of the patients. During tachycardia, the addition of glyceryl trinitrate decreased the tension time index and LVVO2; angina recurred in only 4 patients, and ST depression and lactate extraction improved. Similar haemodynamic changes occurred in the patients with normal coronary arteries. In contrast with propranolol administered alone, propranolol plus glyceryl trinitrate enhances tachycardia tolerance and prevents tachycardia-induced manifestations of ischaemia. This action is attributed to glyceryl trinitrate-associated improvement in the adequacy of myocardial perfusion.
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PMID:Coronary and myocardial metabolic effects of combined glyceryl trinitrate and propranolol administration. Observations in patients with and without coronary disease. 10 30


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