caa a22 4500 475833791 CHVBK 20180406123848.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1023/A:1007889006370 doi (NATIONALLICENCE)springer-10.1023/A:1007889006370 The Effect of Mibefradil on Ischemic Episodes With and Without Increase in Heart Rate [Elektronische Daten] [Dan Tzivoni, Zvi Gilula, Marc Klutstein, Leonardo Reisin, Shulamit Botvin, Isaac Kobrin] Myocardial ischemia during daily life can be induced by increased demand and by increased coronary tone. The purpose of this study was to assess the mechanism of action of mibefradil, a new T-channel calcium blocker that is a vasodilator with negative chronotropic properties. Included in this study were 114 patients with chronic stable angina pectoris and ischemic episodes during baseline 48-hour ambulatory ECG monitoring (AEM). After a placebo run-in period patients received 50 mg, 100 mg, or 150 mg of mibefradil per day and repeat 48 hours AEM was performed. Ischemic episodes were divided into 2 categories: Type I is those in which an increase in heart rate >10% preceded the development of 1 mm ST depression; Type II is those with ≤10% increase in heart rate. Of the 625 ischemic episodes recorded at baseline, 83% were Type I and 17% were Type II. At 50 mg mibefradil dose, there was a significant decrease in the number of Type I ischemic episodes but not of Type II. At doses of 100 mg and 150 mg/day, there was a significant decrease in frequency of both Types of ischemic episodes. At a low dose of 50 mg/day, mibefradil reduces ischemia predominantly by preventing an increase in heart rate, while at higher doses of 100 mg and 150 mg/day, it also acted as a vasodilator suppressing episodes associated with increased coronary tone. Kluwer Academic Publishers, 2000 ambulatory ECG monitoring nationallicence myocardial ischemia nationallicence coronary tone nationallicence T-channel calcium antagonist nationallicence mibefradil nationallicence silent ischemia nationallicence Tzivoni Dan Jesselson Heart Center, Shaare Zedek Medical Center, Israel aut Gilula Zvi Department of Statistics, Hebrew University, Jerusalem aut Klutstein Marc Jesselson Heart Center, Shaare Zedek Medical Center, Israel aut Reisin Leonardo Barzilai Hospital, Ashkelon aut Botvin Shulamit Kaplan Hospital, Rehovot aut Kobrin Isaac F. Hoffmann-LaRoche, Israel aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/5(2000-10-01), 503-509 0920-3206 14:5<503 2000 14 10557 https://doi.org/10.1023/A:1007889006370 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007889006370 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tzivoni Dan Jesselson Heart Center, Shaare Zedek Medical Center, Israel aut NATIONALLICENCE 700 1- Gilula Zvi Department of Statistics, Hebrew University, Jerusalem aut NATIONALLICENCE 700 1- Klutstein Marc Jesselson Heart Center, Shaare Zedek Medical Center, Israel aut NATIONALLICENCE 700 1- Reisin Leonardo Barzilai Hospital, Ashkelon aut NATIONALLICENCE 700 1- Botvin Shulamit Kaplan Hospital, Rehovot aut NATIONALLICENCE 700 1- Kobrin Isaac F. Hoffmann-LaRoche, Israel aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/5(2000-10-01), 503-509 0920-3206 14:5<503 2000 14 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer