Effects of short-term treatment of Nicorandil on exercise-induced myocardial ischemia and abnormal cardiac autonomic activity in microvascular angina

Jaw Wen Chen, Wen Lieng Lee, Nai Wei Hsu, Shing Jong Lin, Chih Tai Ting, Shih Pu Wang, Mau Song Chang

研究成果: 雜誌貢獻文章同行評審

79 引文 斯高帕斯(Scopus)

摘要

The underlying mechanisms of myocardial ischemia in microvascular angina may include endothelial dysfunction, abnormal smooth muscle tone, and abnormal autonomic control of coronary microvasculatures. This randomized, double-blind, placebo-controlled, crossover study was conducted to evaluate the effect of nicorandil (a nitrate-potassium channel opener) therapy on exercise-induced myocardial ischemia and cardiac autonomic activity in 13 patients with microvascular angina. After a 2-week placebo run-in period, patients were randomly assigned to the first 2-week treatment with nicorandil 5 mg tid or placebo, then crossed over to the second 2-week treatment after a 2-week washout period. Treadmill exercise tests and 24-hour ambulatory electrocardiogram monitoring were performed at the end of each treatment phase. The results showed that both time to 1 -mm ST depression and total exercise duration were significantly prolonged with nicorandil treatment compared with placebo (p = 0.026 and 0.036, respectively). Maximum exercise ST depression also tended to be less with nicorandil treatment than with placebo (p = 0.083). Compared with 10 healthy control subjects, study patients had significantly reduced heart rate variability in both low- and high-frequency bonds while receiving placebo. Nicorandil treatment did not change the altered heart rate variability in either time domain or spectral analysis. Systemic hemodynamics were also unchanged with nicorandil treatment. Thus, 2-week oral nicorandil therapy moderately improved exercise- induced myocardial ischemia without modifying the already altered cardiac autonomic activity, suggesting that nicorandil might have a direct vasodilatory effect on coronary microvasculatures in patients with microvascular angina.
原文英語
頁(從 - 到)32-38
頁數7
期刊American Journal of Cardiology
80
發行號1
DOIs
出版狀態已發佈 - 7月 1 1997
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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