Effects of bamiphylline on exercise testing in patients with syndrome X

Gaetano A. Lanza, Achille Gaspardone, Vincenzo Pasceri, Michele Perino, Giuseppe Colonna, Fabrizio Tomai, Filippo Crea, Pier A. Gioffrè, Attilio Maseri

Research output: Contribution to journalArticlepeer-review


An abnormal stimulation of adenosine A1-receptors has been suggested to play a role in the pathogenesis of both chest pain and ischemia-like electrocardiographic changes in patients with syndrome X and a nonselective adenosine antagonist (theophylline) has been reported to be beneficial in these patients. In this study we investigated the acute effects of bamiphylline, a specific A1-receptor antagonist, in 16 patients with syndrome X (14 women, age 57 ± 6 years), with both angina and ST-segment depression inducible during exercise testing. All patients underwent two treadmill exercise tests (Bruce modified protocol) on 2 separate days, 5 minutes after the end of randomized intravenous infusion of either placebo (saline solution) or bamiphylline (300 mg). Severity of chest pain was assessed by a 10 mm visual analogic scale. There were no significant differences in resting heart rate and blood pressure after bamiphylline or placebo. Rate-pressure product (20600 ± 5000 vs 20200 ± 5200 bpm · mmHg), time to 1 mm ST depression (549 ± 196 vs 581 ± 201 sec), time to angina (519 ± 209 vs 571 ± 196 sec), and exercise duration (717 ± 134 vs 676 ± 166 sec) were also not significantly different after bamiphylline or placebo, but there was a mild reduction of the severity of exercise-induced chest pain (30 ± 22 vs 39 ± 20 mm, p <0.05) with the active drug. Thus, in patients with syndrome X, bamiphylline does not improve exercise-induced ST changes, suggesting that A1-receptors are not significantly involved in their appearance. In addition, bamiphylline had little effect on anginal pain, suggesting that this cannot be mediated exclusively by A1-receptor stimulation in these patients.

Original languageEnglish
Pages (from-to)50-54
Number of pages5
JournalGiornale Italiano di Cardiologia
Issue number1
Publication statusPublished - Jan 1997


  • bamiphylline
  • exercise testing
  • syndrome X

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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