Effect of nicorandil on left ventricular end-diastolic pressure during exercise in patients with hypertrophic cardiomyopathy.

Abstract

AIMS:

Impaired coronary microcirculation is thought to contribute to myocardial ischaemia, causing an abnormal increase in left ventricular end-diastolic pressure during exercise in individuals with hypertrophic cardiomyopathy. The effects of nicorandil on left ventricular end-diastolic pressure during exercise were examined in patients with this condition.

METHODS AND RESULTS:

Left ventricular pressures and dimensions were measured simultaneously during supine bicycle exercise in 23 patients with nonobstructive hypertrophic cardiomyopathy, before and after intravenous injection of either nicorandil (0.1 mg/kg) or propranolol (0.15 mg/kg). Exercise thallium-201 scintigraphy was also performed. Patients were grouped according to the changes in left ventricular end-diastolic pressure during exercise before treatment. Group I comprised 13 patients in whom left ventricular end-diastolic pressure increased progressively to abnormal values during exercise; group II comprised 10 patients in whom left ventricular end-diastolic pressure changed biphasically. The extents of both left ventricular hypertrophy and ischemic burden during exercise were greater in group I than in group II. Of the eight group I patients who received nicorandil, four individuals exhibited biphasic changes in left ventricular end-diastolic pressure during exercise after its administration whereas four subjects showed no such effect of the drug. Left ventricular end-diastolic pressure increased progressively during exercise after propranolol treatment in all 6 group II patients given this drug.

CONCLUSION:

Nicorandil has a salutary effect on the changes in left ventricular end-diastolic pressure during exercise in patients with hypertrophic cardiomyopathy.

• Authors: Hideo Izawa, Mitsunori Iwase, Yasushi Takeichi, Fuji Somura, Kohzo Nagata, Takao Nishizawa, Akiko Noda, Toyoaki Murohara, Mitsuhiro Yokota
• Journal: European heart journal (Eur Heart J) Vol. 24 Issue 14 Pg. 1340-8 (Jul 2003) ISSN: 0195-668X [Print] England
• PMID: 12871691 (Publication Type: Journal Article)

Chemical References

• Antihypertensive Agents
• Nicorandil

Topics

• Adult
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects)
• Cardiomyopathy, Hypertrophic (drug therapy, physiopathology)
• Echocardiography
• Exercise
• Exercise Test
• Heart Rate (drug effects)
• Humans
• Male
• Middle Aged
• Nicorandil (therapeutic use)
• Ventricular Dysfunction, Left (drug therapy, physiopathology)