We analyzed the chronic antiischemic effects of Felodipine (F) 10 mg vs Diltiazem slow-release (SR) 240 mg (D) in a single blind, cross-over study, in 10 male patients (pts), mean age 61 ± 5 years, with chronic stable angina, by means of maximal symptom-limited bicycle exercise test, 4 hours after assumption of the drug, after a one week wash out (basal test B) and at the end of two treatment periods of one month each. Results. Felodipine increased heart rate more than Diltiazem both at rest and during effort, probably because of a more important vasodilating effect and consequent lowering of blood pressure. Both drugs significantly ameliorated ischemic parameters. In particular, we saw a reduction of ST segment depression at maximum effort (2 ± 1 in B, 1.2 ± 1 in F, 1.45 ± 1 in D; B vs F and B vs D p <0.03) and at highest double product in common to the 3 tests (1.8 ± 1 mm in B, 0.35 ± 0.6 in F, 1.2 ± 1 in D; B vs F p <0.01, B vs D p <0.05). Ischemic threshold (time to 1 mm ST segment depression) was significantly prolonged with Felodipine and Diltiazem (454 ± 194 sec in B, 546 ± 102 sec in F, 571 ± 108 sec in D; B vs F and B vs D p <0.05) in the presence of a higher double product for Felodipine (26680 ± 5070 in B, 25997 ± 4217 in F, 24121 ± 3907 in D; B vs F p <0.08). It is therefore confirmed the capacity of Felodipine to augment oxygen supply possibly by means of coronary vasodilatation. Conclusions. Felodipine showed coronary antiischemic efficacy comparable to high doses of Diltiazem SR, but with higher capacity to augment coronary blood flow and oxygen-supply at similar oxygen demand. Our data favour a vasodilating effect also present at coronary level that is maintained in chronic therapy with Felodipine, with no development of tolerance.
|Translated title of the contribution||Ergometric study of felodipine versus sutained release diltiazem in patients with ischemic heart disease|
|Number of pages||10|
|Publication status||Published - 1995|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine