Journal of cardiovascular pharmacology
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J. Cardiovasc. Pharmacol. · Jan 1995
Randomized Controlled Trial Clinical TrialDose-range study of a new calcium sensitizer, levosimendan, in patients with left ventricular dysfunction.
Levosimendan, a new drug that sensitizes troponin-C to calcium and selectively inhibits phosphodiesterase III, was administered to 24 patients with ischemic heart disease and ejection fraction below 40%. In a placebo-controlled, crossover, double-blind study, each patient received two intravenous doses of levosimendan on 2 consecutive study days. The doses were 0.25 mg (n = 6), 0.5 mg (n = 11), 1 mg (n = 12), 2 mg (n = 12), and 4 mg (n = 5). ⋯ Total peripheral resistance decreased significantly only after 2 and 4 mg, by 13 and 21%, respectively. However, there were no statistically significant changes in pulmonary vascular resistance. It is concluded that levosimendan has a hemodynamically favorable action after 0.25 and 0.5 mg but that decreases in filling pressures probably prevented the increase in stroke volume and caused a reflex increase in heart rate after 2 and 4 mg.
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J. Cardiovasc. Pharmacol. · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic and humoral effects at rest and after head-up tilt tests during 24-hour infusion of a new nitrate ester, ITF 296, compared with ISDN and placebo in healthy volunteers: a double-blind, randomized, within-subject study.
A double-blind, randomized, three-way complete crossover study was carried out to compare pharmacodynamic effects and tolerability during a 24-h intravenous infusion of ITF 296, isosorbide dinitrate (ISDN), and placebo, in the supine position and during 70 degrees head-up tilt. Ten healthy men aged 21-34 years participated in the study to obtain complete data in nine. Dosing started at 1 microgram/kg/min and was titrated up during the first 30 min of infusion, to produce a 10% reduction in diastolic blood pressure (DBP). ⋯ ISDN caused significantly greater neurohumoral counter-regulation than ITF 296. Hemodynamic response to tilt was attenuated, as judged by the fact that hypotension occurred only during the early hours of the infusion, but the variability in the response of BP to tilt does not allow any firm conclusions to be drawn about possible development of tolerance. Tolerability of ISDN was poor and that of ITF 296 was better.
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J. Cardiovasc. Pharmacol. · Jan 1991
Review Randomized Controlled Trial Clinical TrialAntihypertensive treatment: is blood pressure-lowering the only goal?
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J. Cardiovasc. Pharmacol. · Jan 1990
Randomized Controlled Trial Clinical TrialDrug interactions: the new phosphodiesterase inhibitor enoximone and the calcium channel blocker nifedipine in coronary surgery patients--influence on hemodynamics and plasma concentrations.
The calcium channel blocker nifedipine and the new phosphodiesterase (PDE) inhibitor enoximone are used in the treatment of cardiovascular diseases. Since both substances are acting on slow calcium channels and because systemic elimination of these two agents is dependent on oxidative drug metabolizing enzyme activity, this study was performed in order to investigate hemodynamic changes and effects on plasma levels when both substances are given simultaneously. Forty-five patients undergoing aortocoronary bypass grafting were randomly subdivided into three groups: (a) group (n = 15) received 0.3 micrograms/kg/min of nifedipine as an infusion (N patients); (b) group (n = 15) received 0.5 mg/kg of enoximone as a bolus (E patients); and (c) group (n = 15) received nifedipine and enoximone in the same dosages (E + N patients). ⋯ Plasma concentrations of enoximone and enoximone sulfoxide were not affected by nifedipine infusion and showed a comparable course in E and E + N patients. Nifedipine plasma level dropped to values less than 15 ng/ml at the end of extracorporeal circulation in N and E + N patients. It can be concluded that enoximone improved hemodynamics even in patients pretreated with nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)
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J. Cardiovasc. Pharmacol. · Jan 1988
Randomized Controlled Trial Clinical TrialTreatment of hypertensive urgencies and emergencies with nitrendipine, nifedipine, and clonidine: effect on blood pressure and heart rate.
Nitrendipine is a new calcium antagonist of the 1,4-dihydropyridine group with strong vasodilating properties. In a randomized trial involving 45 patients, whose mean blood pressure was 236 +/- 24/129 +/- 21 mm Hg, 5 mg nitrendipine (given sublingually via a phiole) was compared with 20 mg nifedipine (given sublingually via two pierced 10-mg capsules) and 0.15 mg clonidine (given intravenously). Blood pressure and heart rate were assessed for 8 h after intake of the antihypertensive agents. ⋯ Main side effects were observed in the nifedipine group (flush and reflex tachycardia) and in the clonidine group (dry mouth and drowsiness). In conclusion, nitrendipine, nifedipine, and clonidine show similar efficacy in the treatment of hypertensive urgencies and emergencies. However, sublingual application of the calcium antagonists is simple and safe; moreover, nitrendipine is better tolerated than nifedipine and clonidine.