ergoline and Arrhythmias--Cardiac

Recent experimental and clinical data have stimulated interest in the use of alpha-adrenergic antagonists in acute myocardial infarction. We evaluated nicergoline, a new relatively selective alpha 1-antagonist which uniquely lowers heart rate. Open-chest dogs, randomized to control (n = 25) or intravenously treated group (n = 20; 0.5 mg/kg bolus, then 0.10 to 0.15 mg/kg/min), underwent coronary artery occlusion (CAO) followed after 25 minutes by coronary artery reperfusion (CAR). Nicergoline decreased heart rate by 47 +/- 5 bpm and mean aortic pressure by 39 +/- 4 mm Hg. Following CAO, nicergoline reduced total coronary collateral resistance (radiolabeled microspheres; 698 +/- 75 vs 2167 +/- 530 mm Hg/ml/min/gm, p less than 0.05), increased the ischemic zone/nonischemic zone flow ratio (0.14 +/- 0.04 vs 0.06 +/- 0.02, p less than 0.05), and reduced the rise in intramyocardial CO2 tension in the ischemic zone (mass spectrometry, p less than 0.001). Furthermore, the drug decreased the rate of ventricular tachycardia (VT; 191 +/- 13 vs 243 +/- 3 bpm, p less than 0.001) and the incidence of ventricular fibrillation (VF; 1 of 20 [5%] vs 7 of 25 [28%], p less than 0.05). Following CAR, nicergoline did not significantly reduce the incidence of VF but did lower rate (154 +/- 8 vs 212 +/- 10 bpm, p less than 0.001) and incidence (p less than 0.05) of VT. Thus nicergoline reduced severity of ischemia and afforded protection against arrhythmias induced by myocardial ischemia and reperfusion. The observed reduction in heart rate may have contributed importantly to these beneficial effects. Clinical investigation of this potentially useful vasodilator seems warranted.

Topics: Animals; Arrhythmias, Cardiac; Arterial Occlusive Diseases; Carbon Dioxide; Coronary Circulation; Dogs; Dose-Response Relationship, Drug; Ergolines; Female; Heart Rate; Male; Myocardial Infarction; Nicergoline; Partial Pressure; Perfusion; Phenylephrine; Pressure; Vascular Resistance

Topics: Antiparkinson Agents; Arrhythmias, Cardiac; Ergolines; Humans; Levodopa; Parkinson Disease; Pergolide

Pergolide mesylate, a semisynthetic ergoline and a potent, long-acting central dopamine agonist, was tested in 13 patients with advanced Parkinson disease and diurnal oscillations in performance ("wearing-off" or "on-off" phenomena or both) whose response to levodopa had diminished considerably. Among all nine patients who completed the initial clinical trial, pergolide alone (two patients) or combined with levodopa (seven patients) had a marked antiparkinson effect. There was a significant reduction (p less than 0.05) in rigidity, bradykinesia, gait disorder and total Parkinson disease disability score. Pergolide had a marked effect in all the patients with "wearing-off" or "on-off" phenomena or both, resulting in a significant increase (p less than 0.01) in the duration of the time patients were "on." the number of hours in which patients were "on" increased from 3.8 +/- 0.5 (SEM) to 11.4 +/0 ).8 (SEM). The main daily dose of pergolide was 2.4 mg (range, 2 to 5 mg). Ten months later, all nine patients are doing well. Pergolide is an effective drug in patients with advanced Parkinson disease and reduces "on-off" phenomena.

Topics: Aged; Arrhythmias, Cardiac; Brain; Dopamine; Double-Blind Method; Ergolines; Humans; Levodopa; Middle Aged; Neurons; Parkinson Disease; Pergolide; Random Allocation

We examined the effect of pergolide, a semisynthetic ergot alkaloid, alone or combined with carbidopa and levodopa (Sinemet), on the cardiac rhythm of 12 patients with Parkinson's disease. The patients were selected on the basis of severe Parkinson's disease and stable cardiac rhythm as determined by 1 to 5 days of Holter monitoring. Monitoring was then carried out for an additional period of between 2 and 10 wk while the patients were on pergolide. Seven of the 12 patients had repetitive ventricular rhythms (RVRs). These were isolated, infrequent, and not associated with increases in premature ventricular contractions. The dose at which the RVRs occurred may be a function of the presence or absence of heart disease, but the significance of RVRs remains to be determined.

Topics: Aged; Antiparkinson Agents; Arrhythmias, Cardiac; Carbidopa; Drug Therapy, Combination; Ergolines; Heart; Heart Rate; Humans; Levodopa; Middle Aged; Pergolide