Hemodynamic basis of antianginal effect of calcium antagonists in patients with ischemic heart disease after aortocoronary shunting: myocardial reserve potentials and their mechanisms
Knyshov, G.V.; Vykhovaniuk, I.V.; Tkhor, N.V.; Furkalo, S.N.; Korchinskaia, O.I.
Kardiologiia 33(12): 64-69
1993
ISSN/ISBN: 0022-9040 PMID: 8196260 Document Number: 421265
The pharmacodynamic features of calcium antagonists were studied in 111 ischemic heart disease patients with class II-IV angina reccurrence approximately 37 months after aortocoronary bypass surgery. Drug were selected using veloergometry. Finoptin (120 mg) was found to be effective in 49 patients and corinfar (20 mg) in 62 patients. After the selection of drugs, patients underwent dynamic radionuclide ventriculography with Tc-99M pertechnetate in the initial state and two hours after the administration of the drugs. Three types of hemodynamic reactions were determined taking into consideration the dynamics of speed and temporal systolodiastolic parameters: "systole", "systole-diastole" and "diastole". The reserve potentials of the myocardium were evaluated on the basis of the reaction of functional volumes in a concrete systolodiastolic structure. It was found that the realization of these potentials is ensured by the participation of two compensation mechanisms: myocardial contractility itself and the Frank-Starling mechanism. The role of the latter increases as the functional potentials of the myocardium decrease.