caa a22 4500 475833783 CHVBK 20180406123848.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1023/A:1007841223208 doi (NATIONALLICENCE)springer-10.1023/A:1007841223208 Hemodynamic, Antiischemic, and Neurohumoral Effects of Tedisamil and Atenolol in Patients with Coronary Artery Disease [Elektronische Daten] [Veselin Mitrovic, Aleksandra Miskovic, Matthias Straub, Jochen Thormann, Heinz Pitschner, Christian Hamm] Clinical drawbacks of beta-blocker treatment in stable angina have motivated researchers to provide alternative heart-rate-lowering agents, such as tedisamil, which additionally exerts antiischemic and antiarrhythmic effects by blockade of cellular repolarizing K+ currents. Forty-eight patients with stable angina pectoris were investigated (doubleblind, randomized, parallel grouped) comparing the hemodynamic, antiischemic, metabolic and neurohumoral effects of tedisamil 100 mg b.i.d. and atenolol 50 mg b.i.d. after a single dose and over 6 days of treatment. Tedisamil and atenolol produced a decrease in heart rate both at rest [day 1:-13.6 versus −15.4 bpm; day 6: −14.8 versus −22.2 bpm, resp.; p > 0.05] and exercise [day 1; −9.1 versus −18.3 bpm; p = 0.001; day 6; −12.0 versus −24.8 bpm, resp.; p = 0.001], while anginal threshold increased. Cardiac output decreased with tedisamil and atenolol at rest [day 1: −1.01 versus −1.19 l/min; p > 0.05; day 6: −0.86 versus −1.10 l/min, resp.; p > 0.05] and exercise [day 1: −0.82 versus −1.28 l/min; p > 0.05; day 6: −0.65 versus −2.68 l/min, resp.; p = 0.03], while stroke volume remained unchanged. Right atrial pressure changed during exercise only: it decreased with tedisamil (−1.7 mmHg) and increased with atenolol (+3.7 mmHg) (p < .001). Mean pulmonary capillary wedge pressures decreased both at rest (−0.5 mmHg) and exercise (−6.9 mmHg) in the tedisamil group but tended to increase with atenolol on day 6 of treatment [rest: +1.7; exercise: +3.7 mmHg) (p = 0.03). Arterial pressure decreased under atenolol treatment only. Exercise-induced plasma norepinephrine levels were reduced by tedisamil (−93 pg/ml) but elevated by atenolol (+172 pg/ml) (p = 0.001). As compared to atenolol, tedisamil produced a prolongation of QTc interval [+31 versus 8 ms] at initial values of 0.408 ± 0.018 s with PQ and QRS remaining unaltered. In patients with stable angina, tedisamil (100 mg b.i.d.) as compared to atenolol (50 mg b.i.d.) generated similar hemodynamic, neurohumoral and antiischemic effects. The antiischemic efficacy of tedisamil, as measured by ST segment depression and angina threshold, was comparable to that of atenolol. Kluwer Academic Publishers, 2000 tedisamil nationallicence beta blockers nationallicence coronary artery disease nationallicence hemodynamics nationallicence right-heart catheterization nationallicence catecholamines nationallicence Mitrovic Veselin Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut Miskovic Aleksandra Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut Straub Matthias Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim aut Thormann Jochen Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut Pitschner Heinz Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut Hamm Christian Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/5(2000-10-01), 511-521 0920-3206 14:5<511 2000 14 10557 https://doi.org/10.1023/A:1007841223208 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007841223208 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mitrovic Veselin Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut NATIONALLICENCE 700 1- Miskovic Aleksandra Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut NATIONALLICENCE 700 1- Straub Matthias Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim aut NATIONALLICENCE 700 1- Thormann Jochen Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut NATIONALLICENCE 700 1- Pitschner Heinz Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut NATIONALLICENCE 700 1- Hamm Christian Kerckhoff-Klinik, Max Planck Institute for Physiology and Clinical Research, Bad Nauheim, Germany aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/5(2000-10-01), 511-521 0920-3206 14:5<511 2000 14 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer