piperidines and Angina-Pectoris

Topics: Amiodarone; Angina Pectoris; Benzofurans; Cerebrospinal Fluid Proteins; Electromyography; Humans; Inclusion Bodies; Lipid Metabolism; Microscopy, Electron; Movement Disorders; Muscles; Nervous System Diseases; Paresthesia; Perhexiline; Peripheral Nerves; Peripheral Nervous System Diseases; Pigments, Biological; Piperidines; Polyradiculoneuropathy; Schwann Cells; Skin; Tremor

The authors describe a case of cirrhogenic hepatitis due to Pexid which was given for 8 months at 400 mg/day for a severe angina pectoris. We find here the anatomo-clinical profile of perhexiline maleate hepatiits already described in approximately 20 cases. There was a cirrhogenic evolution in our case as in 5 others : but here cirrhosis was revealing and seems stabilized since the treatment was stopped. The cirrhogenic evolution could be due to a cumulative effect of the drug and/or to an immuno-allergic mechanism as in alcoholic cirrhosis which is very similar, especially from an anatomical point of view. However cirrhogenic hepatitis differs by a characteristic lysosomal overload : brown pigment under microscopic observation and lipolysosomes with in some cases a lamellar structure under electron microscopic observation. The prescription of such a drug should be limited to cases of refractory angina pectoris and needed a regular clinical and biological survey.

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Female; Hepatitis, Alcoholic; Humans; Liver; Liver Cirrhosis; Perhexiline; Piperidines

Topics: Angina Pectoris; Digitalis Glycosides; Dipyridamole; Ethanol; Humans; Isoquinolines; Papaverine; Piperidines; Placebos; Prenylamine; Smoking; Verapamil

To explore the morphological and functional effect of selective and non-selective endothelin (ET)-receptor blockade in coronary artery disease (CAD).. Prospective randomised controlled trial.. University hospital.. 26 patients with stable CAD.. Intracoronary infusion (30 minutes) of the ET-A receptor blocker BQ-123 (40 nmol/min, group A, n = 13) alone or with the ET-B receptor blocker BQ-788 (10 nmol/min, group AB, n = 13) as well.. Fractional flow reserve (FFR), coronary flow reserve (CFR) and intramyocardial resistance (IMR) by PressureWire, mean arterial blood pressure (MAP), minimal lumen diameter (MLD) and average angiographic lumen diameter (mean LD) of the target vessel before and after intracoronary infusion of ET antagonists. Concentrations of C-terminal pro-endothelin-1 (CT-proET1) in arterial blood were determined before and after infusion.. Mean MLD, mean LD, FFR, CFR, IMR and MAP remained unaffected by ET-receptor blockade in both groups; their changes were comparable. Concentrations of CT-proET-1 increased by 6.2 (SD 5.9) pmol/l (95% CI 1.2 to 11.1 pmol/l; p = 0.022) in group A and by 4.1 (SD 4.3) pmol/l (95% CI 1.1 to 7.2 pmol/l; p = 0.014) in group AB.. We found a broad variety of individual haemodynamic responses to ET-receptor antagonists with an overall neutral effect after an infusion period of 30 minutes despite an overall effective blockade of ET-receptors. Prolonged infusion time may be needed to cause a more distinct vasomotor response.. NCT00427232.

Topics: Adult; Aged; Angina Pectoris; Antihypertensive Agents; Coronary Angiography; Coronary Artery Disease; Endothelin Receptor Antagonists; Endothelin-1; Female; Fractional Flow Reserve, Myocardial; Humans; Male; Middle Aged; Myocardial Ischemia; Oligopeptides; Peptides, Cyclic; Piperidines; Prospective Studies; Protein Precursors; Young Adult

Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease.. Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2).. All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031).. Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

Topics: Angina Pectoris; Carbamates; Diabetes Mellitus, Type 2; Electrocardiography; Exercise Test; Female; Humans; Hypoglycemic Agents; Ischemic Preconditioning, Myocardial; Male; Middle Aged; Piperidines; Time Factors

Patients with unstable coronary syndromes are a heterogeneous group with varying degrees of ischemia and prognosis. The present study compares the prognostic value of a standard electrocardiogram (ECG) obtained at admission to the hospital with the information from 24-hour continuous electrocardiographic monitoring obtained immediately after admission. The admission ECGs and 24 hours of vectorcardiographic (VCG) monitoring from 308 patients admitted with unstable coronary artery disease were analyzed centrally regarding standard electrocardiographic ST-T changes, ST-vector magnitude (ST-VM), and ST change vector magnitude episodes. End points were death, acute myocardial infarction, and refractory angina pectoris within a 30-day follow-up period. ST-VM episodes (> or = 50 microV for > or = 1 minute) during VCG monitoring was the only independent predictor of death or acute myocardial infarction by multivariate analysis. ST-VM episodes during vectorcardiography was associated with a relative risk of 12.7 for having a cardiac event, hypertension was associated with a relative risk of 1.7, and ST depression on the admission ECG was associated with a relative risk of 5.7. Patients with ST depression at admission had an event rate (death or acute myocardial infarction) of 17% at 30-day follow-up. Patients without ST depression could further be risk stratified by 24 hours of VCG monitoring into a subgroup with ST-VM episodes at similar (8%) risk and a subgroup without ST-VM episodes at low (1%) risk (p = 0.00005). Continuous VCG monitoring provides important information for evaluating patients with unstable coronary artery disease. It is recommended that patients not initially estimated at high risk based on the admission ECG are referred for 24 hours of VCG monitoring for further risk stratification.

Topics: Aged; Angina Pectoris; Angina, Unstable; Anticoagulants; Antithrombins; Coronary Disease; Electrocardiography; Electrocardiography, Ambulatory; Female; Follow-Up Studies; Glycine; Heparin; Humans; Hypertension; Male; Multivariate Analysis; Myocardial Infarction; Myocardial Ischemia; Patient Admission; Piperidines; Prognosis; Recurrence; Risk Assessment; Risk Factors; Survival Rate; Vectorcardiography

Single doses of ketanserin (20 or 40 mg) and placebo were compared in a double-blind cross-over study in 10 patients with chronic stable angina treated with a beta-adrenoceptor antagonist. Ketanserin had no significant effect on the exercise time to angina, the rate of ST segment depression, or the circulatory response to exercise. The 95% confidence limits indicate that ketanserin is unlikely to increase exercise time to angina by more than 20%.

Topics: Adrenergic beta-Antagonists; Adult; Angina Pectoris; Antihypertensive Agents; Blood Pressure; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Electrocardiography; Exercise Test; Female; Heart Rate; Humans; Ketanserin; Male; Middle Aged; Piperidines

Topics: Angina Pectoris; Clinical Trials as Topic; Coronary Disease; Humans; Perhexiline; Physical Exertion; Piperidines; Placebos

Topics: Adult; Aged; Angina Pectoris; Blood Pressure; Clinical Trials as Topic; Double-Blind Method; Electrocardiography; Exercise Test; Female; Heart Rate; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Verapamil

Topics: Angina Pectoris; Clinical Trials as Topic; Double-Blind Method; Humans; Perhexiline; Piperidines

A random single-blind study of oxprenolol against perhexiline has been undertaken in angina pectoris. Both drugs were effective in treatment (P less than 0.01) but perhexiline was better than oxprenolol (P less than 0.05), 12 of the 14 patients preferring perhexiline. Offset against this was the greater incidence of side effects with perhexiline, including one patient who later developed peripheral neuropathy. Despite the greater efficacy of perhexiline, it is suggested that side effects should preclude its routine prescription as a drug of first choice in angina pectoris. It should remain of value in the special situations of resistant angina and angina with heart failure or bronchospasm, when its use should be carefully monitored for these side effects.

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Oxprenolol; Perhexiline; Piperidines; Random Allocation

The antianginal effect of perhexiline was evaluated in a placebo-controlled double-blind study of 20 patients with stable angina pectoris. Only patients with documented myocardial infarction of more than 6 months' standing and with ST-segment depression on exercise were admitted to the study. Objective parameters of bicycle stress tests at a submaximum level of 50 watts and a maximum exercise level were evaluated. Subjective data such as nitroglycerin consumption and incidence of anginal attacks per week were obtained from the patients' self-maintained records. No negative chronotropic effect of perhexiline was found at rest. At a submaximum exercise level with unchanged double-product, a significantly lower heart rate (p less than 0.05) and a significant reduction in ST-segment depression were observed in comparison with the placebo. At maximum exercise level an increase in exercise tolerance of 8.1% and in aerobic capacity of 8.3% resulted in a significant increase in the double-product (p less than 0.01), with a shift in the blood pressure/heart rate ratio. Discontinuation of exercise occurred at the same heart rate, but at a markedly higher level of exercise attainment. Heart rate on exercise proved to be the most valuable parameter in this study for the evaluation of the aerobic capacity of the individual patient. Nitroglycerin consumption and frequency of anginal attacks per week were reduced, but were not of statistical significance. Side-effects occurred in 6 patients, but these did not require termination or reduction of medication. The selective effect on heart rate during exercise opens a new field of application for perhexiline in comparison with beta-blocking agents.

Topics: Adult; Aged; Angina Pectoris; Double-Blind Method; Exercise Test; Heart Rate; Humans; Middle Aged; Myocardial Infarction; Perhexiline; Physical Exertion; Piperidines

Topics: Adult; Angina Pectoris; Chemical Phenomena; Chemistry; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Nitroglycerin; Perhexiline; Physical Exertion; Piperidines; Time Factors

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Maleates; Middle Aged; Perhexiline; Piperidines; Placebos; Prenylamine

Topics: Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Humans; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Maleates; Perhexiline; Piperidines; Placebos

Perhexiline maleate, which has no beta adreno-receptor-blocking activity, has been suggested as an effective prophylactic agent for angina pectoris. The effects of perhexilline were compared with those of placebo by a double-blind crossover trial in seven patients with moderate to severe angina pectoris. Attack rates and glyceryl trinitrate consumption were significantly lower during the perhexilline phase than during the placebo phase of treatment. There was also a mild fall in resting heart rate. Three patients who had failed to respond to beta adrenoreceptor-blocking drugs, and one who had suffered reccurrence of symptoms after coronary artery surgery responded favourably to perhexiline. It thus appears that perhexiline maleate is an effective and potentially valuable agent in this condition.

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Depression, Chemical; Female; Heart Rate; Humans; Male; Middle Aged; Nitroglycerin; Perhexiline; Piperidines

Topics: Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Nitroglycerin; Perhexiline; Piperidines

Topics: Adrenergic beta-Antagonists; Angina Pectoris; Clinical Trials as Topic; Humans; Perhexiline; Piperidines; Placebos; Research Design

Topics: Aged; Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Humans; Perhexiline; Piperidines; Placebos; Propranolol

Topics: Administration, Oral; Aged; Alanine Transaminase; Angina Pectoris; Animals; Arrhythmias, Cardiac; Aspartate Aminotransferases; Clinical Trials as Topic; Coronary Disease; Dose-Response Relationship, Drug; Drug Evaluation; Electrocardiography; Female; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Contraction; Nitroglycerin; Oxygen Consumption; Perhexiline; Piperidines; Prognosis

Topics: Angina Pectoris; Animals; Arrhythmias, Cardiac; Clinical Trials as Topic; Dogs; Hemodynamics; Humans; Perhexiline; Piperidines; Placebos; Rats

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos

A controlled double blind clinical trial has been conducted in 16 patients with "angina pectoris" in order to investigate the effect of Perexiline maleate as compared with prenilamine. Perexiline at the dose of 400 mg/die and prenilamine at the dose of 120 mg/die have been administered over a period of 4 weeks each. Between these periods placebo has been administered for two weeks. The number of attacks of angina and the number of tablets of nitroglycerine used per week by the patient during each period has been used for the evaluation. Furthermore ECG at rest and after exercise has been performed every two weeks. Our results statistically evaluated show a definite antianginal effect of Perexiline. According to our experience Perexiline should be considered the drug of choise in the treatment of angina complicated by bradicardia, left ventricular failure, bronchospasm, and in angina unresponsive to other drugs.

Topics: Angina Pectoris; Blood Pressure; Body Weight; Drug Evaluation; Electrocardiography; Headache; Humans; Perhexiline; Piperidines; Prenylamine; Pulse; Sleep Wake Disorders

Topics: Adult; Aerobiosis; Angina Pectoris; Clinical Trials as Topic; Exercise Test; Female; Heart Rate; Humans; Male; Maleates; Middle Aged; Oxygen Consumption; Perhexiline; Piperidines; Placebos; Time Factors; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Arteriosclerosis; Blood Pressure; Catheterization; Clinical Trials as Topic; Coronary Circulation; Dyspnea; Fatigue; Female; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Myocardium; Nitroglycerin; Oxygen Consumption; Perhexiline; Physical Exertion; Piperidines; Placebos; Vasodilator Agents

Topics: Aged; Angina Pectoris; Arrhythmias, Cardiac; Aspartate Aminotransferases; Clinical Trials as Topic; Drug Evaluation; Electrocardiography; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Time Factors; Vasodilator Agents

Topics: Administration, Oral; Adult; Aged; Alanine Transaminase; Angina Pectoris; Blood Pressure; Body Weight; Central Nervous System Diseases; Clinical Trials as Topic; Drug Evaluation; Electrocardiography; Female; Gastrointestinal Diseases; Heart Rate; Humans; Male; Middle Aged; Perhexiline; Physical Exertion; Piperidines; Placebos; Tachycardia; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Coronary Disease; Female; Humans; Male; Maleates; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Electrocardiography; Evaluation Studies as Topic; Exercise Test; Female; Humans; Male; Middle Aged; Nitroglycerin; Pentaerythritol Tetranitrate; Perhexiline; Piperidines; Vasodilator Agents; Vertigo

Topics: Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Methods; Perhexiline; Piperidines; Placebos; Vasodilator Agents

Topics: Aged; Angina Pectoris; Blood Pressure; Clinical Trials as Topic; Electrocardiography; Exercise Test; Heart Rate; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Spirometry; Vasodilator Agents; Vital Capacity

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Humans; Outpatient Clinics, Hospital; Perhexiline; Piperidines; Placebos; Prenylamine; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Humans; Perhexiline; Piperidines; Placebos; Practolol; Propranolol; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Liver; Liver Function Tests; Male; Middle Aged; Perhexiline; Piperidines; Time Factors; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Time Factors; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Coronary Disease; Female; Humans; Male; Perhexiline; Piperidines; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Coronary Disease; Enzyme Induction; Enzymes; Humans; Perhexiline; Piperidines; Time Factors; Vasodilator Agents

Topics: Adult; Angina Pectoris; Clinical Trials as Topic; Heart; Heart Ventricles; Humans; Male; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Electrocardiography; Exercise Test; Female; Heart Rate; Humans; Male; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Aged; Angina Pectoris; Clinical Trials as Topic; Exercise Test; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Prenylamine; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Alanine Transaminase; Angina Pectoris; Aspartate Aminotransferases; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Time Factors; Vasodilator Agents

Topics: Angina Pectoris; Chronic Disease; Clinical Trials as Topic; Humans; Middle Aged; Perhexiline; Piperidines; Statistics as Topic; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Anticoagulants; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Transaminases; Vasodilator Agents

Topics: Angina Pectoris; Body Weight; Clinical Trials as Topic; Humans; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Vasodilator Agents

Topics: Aged; Angina Pectoris; Clinical Trials as Topic; Electrocardiography; Evaluation Studies as Topic; Exercise Test; Heart Rate; Humans; Male; Middle Aged; Perhexiline; Physical Exertion; Piperidines; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Dose-Response Relationship, Drug; Evaluation Studies as Topic; Hemodynamics; Humans; Liver; Liver Function Tests; Middle Aged; Perhexiline; Piperidines; Placebos; Vasodilator Agents

Topics: Aged; Angina Pectoris; Clinical Trials as Topic; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Time Factors; Vasodilator Agents

Topics: Angina Pectoris; Blood Pressure; Clinical Trials as Topic; Evaluation Studies as Topic; Humans; Male; Middle Aged; Perhexiline; Piperidines; Placebos; Pulse; Vasodilator Agents

Topics: Angina Pectoris; Clinical Trials as Topic; Drug Evaluation; Drug Tolerance; Electrocardiography; Female; Humans; Male; Maleates; Perhexiline; Piperidines; Vasodilator Agents

Topics: Administration, Oral; Adult; Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Nitroglycerin; Piperidines; Placebos; Vasodilator Agents

Topics: Angina Pectoris; Blood Pressure; Body Weight; Cardiac Output; Clinical Trials as Topic; Cyclohexanes; Diuresis; Drug Tolerance; Electrocardiography; Heart Rate; Humans; Maleates; Myocardium; Nitroglycerin; Oxygen Consumption; Physical Exertion; Piperidines; Placebos; Polyuria; Rest

This paper reports a double-blind trial of a new antianginal drug, perhexiline. Fifty-five patients suffering from angina pectoris were studied for periods of 12 or 24 weeks in a cross-over comparison against a placebo in four centres in the United Kingdom and Ireland. Perhexiline was effective in most patients as judged by reducing the number of anginal attacks in 84% and the consumption of glyceryl trinitrate tablets in 64%. The major side effect, dizziness, noted in one-third of the patients, may be dose/body-weight related. Perhexiline is a valuable new agent for the treatment of patients with angina, especially those who do not respond to other antianginal agents.

Topics: Adult; Aged; Angina Pectoris; Body Weight; Clinical Trials as Topic; Female; Humans; Male; Maleates; Middle Aged; Nitroglycerin; Piperidines; Placebos; Vasodilator Agents

Topics: Aged; Angina Pectoris; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Piperidines; Placebos; Vasodilator Agents

Topics: Acetanilides; Angina Pectoris; Benzazepines; Heart Failure; Humans; Obesity; Piperazines; Piperidines; Pyrazoles; Ranolazine; Rimonabant; Tolvaptan

The antimigraine drugs ergotamine and sumatriptan may cause angina-like symptoms, possibly resulting from coronary artery constriction. We compared the coronary vasoconstrictor potential of a number of current and prospective antimigraine drugs (ergotamine, dihydroergotamine, methysergide and its metabolite methylergometrine, sumatriptan, naratriptan, zolmitriptan, rizatriptan, avitriptan).. Concentration-response curves to the antimigraine drugs were constructed in human isolated coronary artery segments to obtain the maximum contractile response (Emax) and the concentration eliciting 50% of Emax (EC50). The EC50 values were related to maximum plasma concentrations (Cmax) reported in patients, obtaining Cmax/EC50 ratios as an index of coronary vasoconstriction occurring in the clinical setting. Furthermore, we studied the duration of contractile responses after washout of the acutely acting antimigraine drugs to assess their disappearance from the receptor biophase. Compared with sumatriptan, all drugs were more potent (lower EC50 values) in contracting the coronary artery but had similar efficacies (Emax <25% of K+-induced contraction). The Cmax of avitriptan was 7- to 11-fold higher than its EC50 value, whereas those of the other drugs were <40% of their respective EC50 values. The contractile responses to ergotamine and dihydroergotamine persisted even after repeated washings, but those to the other drugs declined rapidly after washing.. All current and prospective antimigraine drugs contract the human coronary artery in vitro, but in view of low efficacy, these drugs are unlikely to cause myocardial ischemia at therapeutic plasma concentrations in healthy subjects. In patients with coronary artery disease, however, these drugs must remain contraindicated. The sustained contraction by ergotamine and dihydroergotamine seems to be an important disadvantage compared with sumatriptan-like drugs.

Topics: Adolescent; Adult; Aged; Angina Pectoris; Child; Coronary Vessels; Dihydroergotamine; Ergotamine; Female; Humans; In Vitro Techniques; Indoles; Male; Methysergide; Middle Aged; Migraine Disorders; Piperidines; Sulfonamides; Sumatriptan; Triazoles; Tryptamines; Vasoconstrictor Agents

The hemodynamic effects of intravenous pirmenol were studied in 21 subjects instrumented with peripheral arterial, pulmonary artery, and left ventricular catheters. Baseline measurements of heart rate, cardiac output, pulmonary artery pressure, systemic arterial pressure, left ventricular end-diastolic pressure, left ventricular stroke work, and ejection fraction were obtained. An infusion of pirmenol hydrochloride was administered and hemodynamic measurements were repeated an average of 16.1 minutes following the start of the infusion after a new stable hemodynamic state was achieved. Significant increases in heart rate and systemic arterial pressure were noted. There were no significant changes in cardiac output, pulmonary arterial pressure, or left ventricular end-diastolic pressure. Significant reductions in left ventricular stroke work and ejection fraction were demonstrated. The amount of decrease in the ejection fraction was not related to the plasma pirmenol level achieved or to the baseline level of ventricular function. These findings suggest a negative inotropic effect of acute infusions of pirmenol and suggest caution should be used in its administration to patients with compromised left ventricular performance.

Topics: Adult; Angina Pectoris; Anti-Arrhythmia Agents; Coronary Disease; Depression, Chemical; Drug Evaluation; Female; Heart Ventricles; Hemodynamics; Humans; Infusions, Intravenous; Male; Middle Aged; Piperidines; Stroke Volume; Time Factors

Because ergonovine appears to produce coronary contractions by a serotonergic (5-HT) mechanism, we attempted to prevent ergonovine-induced ischemia in patients with vasospastic angina by pretreatment with ketanserin, a new selective 5-HT blocker. We studied seven patients with consistently positive results of ergonovine testing (ST segment elevation in three and ST segment depression in four). Ergonovine testing was performed before and after a bolus of 10 mg of ketanserin (all patients) and infusion of 2 to 4 mg/hr for 8 hr (six patients). To assess 5-HT blockade during ketanserin infusion, the constrictor response of hand veins to 5-HT was tested before and after ketanserin. Despite evidence of 5-HT blockade in hand veins, ergonovine-induced ischemia was not prevented by ketanserin in any patient, and there was no significant change in the dose of ergonovine required to provoke ischemia. In one patient, four spontaneous episodes of ST segment elevation occurred during infusion of ketanserin. The plasma concentrations of ketanserin at the time of ergonovine testing ranged from 61 to 127 ng/ml (mean 102) and were well above those that completely inhibit canine coronary 5-HT contractions in vitro. Although human coronary arteries may differ in their responsiveness to 5-HT or ketanserin, these data suggest that ischemia from ergonovine-induced coronary vasospasm is not mediated by 5-HT receptors.

Topics: Aged; Angina Pectoris; Coronary Vasospasm; Coronary Vessels; Ergonovine; Hand; Humans; Ketanserin; Male; Middle Aged; Piperidines; Receptors, Serotonin; Serotonin Antagonists; Vasoconstriction

We performed a double-blind controlled crossover trial of perhexiline maleate versus identical placebo in daily doses of 100-400 mg in 20 male patients who were severely limited with angina pectoris despite therapy with beta-adrenoreceptor blockers. All patients had documented coronary artery disease and were awaiting coronary artery bypass grafting. Beta-blocker therapy was continued unchanged. A significant response compared to placebo was evident after 100 mg of perhexiline, and incremental therapeutic effects were evident up to 400 mg. The mean weekly angina rate fell from 18.2 +/- 2.8 basal to 6.2 +/- 1.5 on 200 mg (P less than 0.05) to 2.8 +/- 0.9 on 400 mg perhexiline (P less than 0.05). Nitroglycerin consumption fell in parallel. The mean exercise duration increased from 261 +/- 57 sec to 384 +/- 75 sec (P less than 0.05). Five patients became asymptomatic on perhexiline, and the number of pain-free days increased 100% (P less than 0.01) compared to placebo. No patient experienced hypotension or heart failure. This study shows that the addition of perhexiline to beta-adrenoreceptor antagonists in patients with severe angina pectoris is effective and represents an alternative therapy.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Angina Pectoris; Double-Blind Method; Drug Resistance; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Debrisoquin; Electromyography; Humans; Hydroxylation; Isoquinolines; Male; Middle Aged; Perhexiline; Peripheral Nervous System Diseases; Phenotype; Piperidines; Polymorphism, Genetic

Topics: Angina Pectoris; Humans; Perhexiline; Piperidines; Premedication

Perhexiline maleate is a potent anti-anginal drug which may cause alcoholic-type hepatitis and cirrhosis. We report a case of a patient who developed cirrhosis on a relatively low dose within 16 mth.

Topics: Aged; Angina Pectoris; Female; Humans; Liver; Liver Cirrhosis; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Female; Humans; Liver Cirrhosis; Male; Perhexiline; Peripheral Nervous System Diseases; Piperidines

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Female; Genes; Hepatitis, Alcoholic; HLA Antigens; HLA-B Antigens; Humans; Middle Aged; Perhexiline; Piperidines

The use of perhexiline maleate as an antianginal agent is occasionally associated with side effects, particularly neuropathy and liver damage. The reason why some individuals develop these toxic reactions is not clear, though some evidence suggests that they may result from impaired oxidative metabolism, due to genetic or hepatic factors, and consequential accumulation of the drug in toxic concentrations. Drug oxidation was measured with an oxidation phenotyping procedure in 34 patients treated with perhexiline, 20 of whom had developed neuropathy and 14 of whom had not. Most of the 20 patients with neuropathy, but not the unaffected patients, showed an impaired ability to effect metabolic drug oxidation. This impairment was independent of hepatic function, concurrent drug therapy, or tobacco or alcohol consumption. The fact that the ability to oxidise several drugs is genetically controlled points to a genetic susceptibility to developing neuropathy in response to perhexiline. Routine determination of the drug oxidation phenotype might lead to safer use of perhexiline by predicting patients who may be more at risk of developing a neuropathic reaction associated with its long-term use.

Topics: Adult; Aged; Alcohol Drinking; Angina Pectoris; Debrisoquin; Female; Humans; Isoquinolines; Liver Function Tests; Male; Middle Aged; Oxidation-Reduction; Perhexiline; Peripheral Nervous System Diseases; Piperidines; Smoking

Perhexiline maleate is an agent currently under investigation in Canada that is used for angina unresponsive to other treatment. This paper describes a possible side effect previously unreported--papilledema not associated with peripheral neuropathy.

Topics: Adult; Angina Pectoris; Fluorescein Angiography; Humans; Male; Papilledema; Perhexiline; Piperidines; Visual Fields

In a 78-year-old woman receiving perhexiline maleate for intractable angina pectoris, a syndrome of parkinsonism and peripheral neuropathy developed. The neuropathy was confirmed by electromyographic and nerve conduction studies. The parkinsonism and peripheral neuropathy disappeared when perhexiline maleate was discontinued.

Topics: Aged; Angina Pectoris; Female; Humans; Parkinson Disease, Secondary; Perhexiline; Peripheral Nervous System Diseases; Piperidines

Topics: Angina Pectoris; Humans; Perhexiline; Piperidines

This paper reports a case of fatal perhexiline maleate liver injury. A 62-year-old man had received perhexiline maleate for 18 months before death. Hepatic failure developed after a routine surgical procedure. The clinical course and histological findings are presented.

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Liver; Liver Cirrhosis, Alcoholic; Liver Diseases; Male; Middle Aged; Osteoarthritis; Perhexiline; Piperidines; Postoperative Complications; Transaminases

Topics: Angina Pectoris; Aniline Compounds; Arrhythmias, Cardiac; Calcium; Cardiomegaly; Diuretics; Heart Diseases; Heart Failure; Humans; Hypertension; Indapamide; Nifedipine; Perhexiline; Piperidines; Pyridines; Verapamil

Topics: Adult; Aged; Angina Pectoris; Biopsy, Needle; Chemical and Drug Induced Liver Injury; Female; France; Hepatomegaly; Humans; Liver; Liver Function Tests; Male; Middle Aged; Perhexiline; Piperidines

A patient developed papilloedema and hepatic dysfunction while being treated with perhexiline maleate. These later regressed when the drug was withdrawn. Patients should be monitored for these potentially serious side-effects while on this drug.

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Male; Middle Aged; Papilledema; Perhexiline; Piperidines

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Male; Middle Aged; Perhexiline; Piperidines; Polyneuropathies; Time Factors

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Three patients with variant angina pectoris resistant to therapy with nitrates and propranolol were treated with perhexilene maleate. Two patients had normal coronary arteries with documented coronary artery spasm, while the third patient had a fixed coronary artery obstruction. In all three patients, attacks of variant angina pectoris disappeared following institution of therapy with perhexilene maleate. When the dose of this drug was decreased to 100 mg per day or less, symptoms reappeared in all patients. Reinstitution of therapeutic doses of perhexilene maleate once again resulted in complete control of symptoms. Perhexilene maleate is therefore a useful agent for the treatment of variant angina pectoris.

Topics: Angina Pectoris; Angina Pectoris, Variant; Coronary Angiography; Drug Evaluation; Electrocardiography; Female; Humans; Male; Middle Aged; Nitroglycerin; Perhexiline; Piperidines

The authors report the cases of 2 patients who died from cirrhosis after receiving perhexiline maleate, a drug widely used in Europe for the treatment of angina pectoris. Perhexiline maleate had been ingested for 24 and 28 mo, respectively. Manifestations of cirrhosis included jaundice, hepatic encephalopathy, ascites, and portal hypertension. Associated manifestations of intolerance to perhexiline maleate included peripheral neuropathy in 1 patient and marked weight loss in both. Histologic lesions resembled those observed in patients with alcoholic liver disease. Ultrastructural lesions included numerous enlarged lysosomes containing myeloid figures. Histochemical stains demonstrated increased phospholipid content of the hepatocytes. These findings are consistent with the view that prolonged administration of perhexiline maleate may induce both histologic lesions resembling those of alcoholic liver disease and ultrastructural and histochemical lesions resembling those of phospholipidosis.

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Cytoplasmic Granules; Female; Hepatic Encephalopathy; Humans; Inclusion Bodies; Liver; Liver Cirrhosis; Male; Middle Aged; Necrosis; Perhexiline; Piperidines

Peripheral neuropathy has been noted as a complication of therapy with perhexiline maleate, a drug widely used in France (and in clinical trials in the United States) for the prophylactic treatment of angina pectoris. In 24 patients with this complication, the marked slowing of motor nerve conduction velocity and the electromyographic changes imply mainly a demyelinating disorder. Improvement was noted with cessation of therapy. In a few cases the presence of active denervation signified a poor prognosis, with only slight improvement. The underlying mechanism causing the neuropathy is not yet fully known, although some evidence indicates that it may be a lipid storage process.

Topics: Adult; Aged; Angina Pectoris; Electromyography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Motor Neurons; Muscular Atrophy; Neural Conduction; Perhexiline; Peripheral Nervous System Diseases; Peroneal Nerve; Piperidines; Ulnar Nerve

Two patients who developed biochemical and histological evidence of hepatitis while taking the anti-anginal drug perhexiline maleate are described. The pathological changes were those of mild to moderate fatty change together with a hepatitis which resembled alcoholic hepatitis, including in one patient the presence of material which by light microscopy was indistinguishable from Mallory's alcoholic hyalin. However, the predominantly periportal location of this material contrasted with the centrilobular distribution of Mallory's hyaline. One patient showed, in addition, severe atypia of the hepatocytes which was still present in less pronounced form 10 weeks after stopping perhexiline. The other patient had advanced hepatic fibrosis.

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Liver; Male; Middle Aged; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Angina Pectoris, Variant; Electrocardiography; Ergonovine; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Nifedipine; Perhexiline; Piperidines; Pyridines

Topics: Angina Pectoris; Body Weight; Humans; Liver Diseases; Neuromuscular Diseases; Perhexiline; Piperidines

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Liver Cirrhosis; Male; Perhexiline; Piperidines; Time Factors

Perhexiline maleate was used as a prophylactic agent in 26 patients suffering from severe angina pectoris. The mean duration of treatment was 8.9 months, with a maximum of 28 months. Fifteen patients experienced a reduction in frequency of attacks to less than one-third of their previous level; six experienced a reduction to two-thirds of their previous level; no patient showed an increase in attack rates. During the period of study, there was one death. Frequently observed side effects included dizziness, gastrointestinal irritation and malaise. One patient developed clinically apparent hepatic dysfunction which resolved on withdrawal of perhexiline maleate, but recurred after rechallenge with a lower dose of the drug; the results of liver function tests in five others showed mild abnormalities. One patient developed peripheral neuropathy after taking perhexiline maleate for 18 months, but this resolved in two months after cessation of therapy. Good responses to perhexiline maleate were observed in patients who were concurrently treated with beta-adrenoreceptor blocking drugs.

Topics: Alprenolol; Angina Pectoris; Drug Therapy, Combination; Electrocardiography; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines; Propranolol

A five-year personal experience of the use of perhexiline maleate (Pexid) in the treatment of severe angina pectoris is presented. Ninety-four patients, all severely incapacitated by cardiac pain, received perhexiline maleate for an average period of 12.2 months. Perhexiline maleate was used either alone or, more commonly, in conjuction with other antianginal therapy, such as beta-adrenergic receptor blocking agents. The results demonstrate that perhexiline maleate is a very effective agent which appears to be safe for long-term usage. Side effects have been frequent, and occasionally bothersome, but all have been transient and dose-dependent. The possibility that the regimens of treatment may materially improve long-term prognosis is raised.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Angina Pectoris; Australia; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Myocardial Infarction; Perhexiline; Piperidines; Prognosis

The aim of this study was to estimate the frequency of latent perhexiline-induced neuropathy in man. Several electrophysiological parameters were recorded and compared between a control group and a group of treated patients, without clinical evidence of neuropathy. The Hmax/Mmax amplitude ratio of the soleus H reflex was decreased in 2/3 of the patients. The H reflex latency was increased in 1/3 of them. The distal motor latencies of ulnar and popliteal nerves were increased in 1/4 of them. Only 1/3 of the patients treated did not show any electrophysiological abnormality. The validity of these results and the possible mechanisms involved are discussed.

Topics: Adult; Aged; Angina Pectoris; Electric Stimulation; Evoked Potentials; H-Reflex; Humans; Middle Aged; Neural Conduction; Perhexiline; Peripheral Nerves; Peripheral Nervous System Diseases; Piperidines

Five patients developed a mild to severe polyneuropathy while under treatment with perhexiline maleate, a drug used in long-term treatment of angina pectoris. Recovery took place within a few months after drug withdrawal. We performed qualitative and quantitative light and electron microscopical studies, including teased fiber preparations, in different patients; 16 to 90% of the fibers showed segmental demyelination, an unusual feature in drug-induced neuropathies, and 3 to 20% were undergoing wallerian degeneration. Severe loss of myelinated axons was noted in all 5 patients. In these patients clinical symptoms occurred only when a great number of fibers had already been lost and most of the surviving fibers showed demyelination.

Topics: Aged; Angina Pectoris; Demyelinating Diseases; Female; Humans; Male; Middle Aged; Nerve Fibers; Perhexiline; Peripheral Nervous System Diseases; Piperidines

Topics: Adult; Angina Pectoris; Female; Humans; Intracranial Pressure; Male; Middle Aged; Papilledema; Perhexiline; Piperidines

Topics: Angina Pectoris; H-Reflex; Humans; Nervous System Diseases; Perhexiline; Piperidines

Topics: Angina Pectoris; Body Weight; Chemical and Drug Induced Liver Injury; Diabetes Complications; Diabetes Mellitus; Humans; Hypoglycemia; Neurologic Manifestations; Perhexiline; Piperidines; Polyneuropathies; Triglycerides

Topics: Acute Kidney Injury; Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Drug Synergism; Female; Halothane; Humans; Perhexiline; Piperidines

Topics: Angina Pectoris; Diagnosis, Differential; Hepatitis, Alcoholic; Humans; Liver Cirrhosis; Male; Middle Aged; Perhexiline; Piperidines; Time Factors

Topics: Angina Pectoris; Humans; Perhexiline; Piperidines

Perhexiline maleate (Pexid) which has been in general use in France with good results for the treatment of angina pectoris since 1973, may be associated with severe side effects including peripheral neuropathy. The present study is a comparison of the pharmacokinetics of perhexiline maleate in anginal patients with and without signs of peripheral neuropathy. Compared to the latter, those with neuropathy had higher plasma levels of perhexiline, slower hepatic metabolism and a longer plasma half-life. Thus, peripheral neuropathy associated with perhexiline maleate treatment appears to be a direct toxic effect due to accumulation of the drug. The accumulation might result either from a decreased volume of distribution secondary to a loss of body weight, possibly drug-induced, or to slow hepatic metabolism of perhexiline of genetic origin or due to hepatic disease, possibly drug-induced. The neuropathy is rarely an isolated event, as it is often associated with one or more adverse effects of perhexiline.

Topics: Aged; Angina Pectoris; Female; Humans; Kinetics; Male; Middle Aged; Nervous System Diseases; Perhexiline; Piperidines; Time Factors

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Male; Middle Aged; Perhexiline; Piperidines

The pathological findings in four nerves and muscles and in one skin biopsies from four patients treated with perhexiline maleate for angina pectoris are reported. In every case, a muscular denervation atrophy and a decrease in the large diameter myelinated fibers were observed. Only one case showed a decrease of the total number of myelinated fibers, on quantitative studies. The electron microscopic study of each nerve displayed findings consistent with a predominant schwannian degeneration, associated with a few onion bulbs formations and, in two cases, with a mild wallerian degeneration. The most striking finding consisted in the presence of polymorphous membrane-bound inclusions reminding the morphology of lysosomal complex lipids. These structures were very abundant in Schwann cells, but they were seen also in fibrocytes, endothelial and pericytic cells. Similar inclusions were present in the single muscle and skin biopsies studied by electron microscopy. In the muscle, they were seen in muscular cells as well as in endothelial and pericytic cells. In the skin, similar inclusions were observed in endothelial, smooth muscle and sweat gland cells. These inclusions were difficult to identify in one micron thick sections, emphazing the need of ultrastructural study for diagnostic purposes.

Topics: Aged; Angina Pectoris; Female; Humans; Male; Microscopy, Electron; Middle Aged; Muscles; Muscular Atrophy; Nerve Degeneration; Perhexiline; Peripheral Nerves; Peripheral Nervous System Diseases; Piperidines; Schwann Cells; Skin

Topics: Adult; Aged; Angina Pectoris; Electromyography; Female; Humans; Long-Term Care; Male; Middle Aged; Neural Conduction; Perhexiline; Peripheral Nervous System Diseases; Piperidines

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Female; Humans; Liver; Perhexiline; Piperidines

Topics: Amiodarone; Angina Pectoris; Benzofurans; Humans; Isosorbide Dinitrate; Perhexiline; Piperidines

Topics: Adult; Angina Pectoris; Humans; Jaundice; Male; Perhexiline; Piperidines

Topics: Aged; Angina Pectoris; Female; Humans; Muscular Diseases; Perhexiline; Piperidines

Hypoglycaemia occurred in two patients treated with perhexiline maleate. The responsibility of the medication is discussed in each case. Blood insulin levels were increased. Blood perhexiline levels decreased very rapidly in the first patient, though much more slowly in the second.

Topics: Aged; Angina Pectoris; Blood Glucose; Female; Glucagon; Humans; Hypoglycemia; Insulin; Male; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Arrhythmias, Cardiac; Drug Evaluation; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Animals; Arteriosclerosis; Disease Models, Animal; Electrocardiography; Heart Rate; Male; Perhexiline; Piperidines; Rabbits

Topics: Adult; Aged; Angina Pectoris; Exercise Test; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Amiodarone; Angina Pectoris; Benzofurans; Humans; Perhexiline; Piperidines

Topics: Angina Pectoris; Animals; Humans; Perhexiline; Piperidines

Topics: Adult; Aged; Angina Pectoris; Female; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Cardiac Complexes, Premature; Congresses as Topic; Coronary Disease; Germany, West; Humans; Maleates; Perhexiline; Piperidines

Topics: Aged; Angina Pectoris; Humans; Male; Maleates; Paresthesia; Parkinson Disease, Secondary; Perhexiline; Peripheral Nervous System Diseases; Piperidines

Topics: Aged; Angina Pectoris; Female; Humans; Hypoglycemia; Maleates; Perhexiline; Piperidines

Topics: Aged; Angina Pectoris; Drug Evaluation; Humans; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Drug Evaluation; Echocardiography; Electrocardiography; Heart; Humans; Perhexiline; Phonocardiography; Piperidines

Topics: Administration, Oral; Adult; Aged; Angina Pectoris; Coronary Disease; Electrocardiography; Female; Humans; Male; Maleates; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Electrocardiography; Perhexiline; Piperidines; Vasodilator Agents

Topics: Aged; Angina Pectoris; Electrocardiography; Humans; Male; Perhexiline; Piperidines; Vasodilator Agents

Topics: Adult; Angina Pectoris; Blood Flow Velocity; Blood Pressure; Cardiac Output; Coronary Circulation; Coronary Vessels; Heart Rate; Humans; Lactates; Middle Aged; Myocardium; Oxygen Consumption; Pacemaker, Artificial; Perhexiline; Piperidines; Tachycardia; Vascular Resistance; Vasodilator Agents

Topics: Adult; Aged; Angina Pectoris; Electrocardiography; Female; Humans; Male; Middle Aged; Nitroglycerin; Perhexiline; Piperidines; Vasodilator Agents

Topics: Angina Pectoris; Evaluation Studies as Topic; Heart Ventricles; Hemodynamics; Humans; Perhexiline; Physical Exertion; Piperidines; Vasodilator Agents

Topics: Angina Pectoris; Animals; Blood Flow Velocity; Blood Pressure; Cardiac Output; Coronary Vessels; Dogs; Heart Rate; Hemodynamics; Indicator Dilution Techniques; Oxygen Consumption; Piperidines; Stimulation, Chemical; Vascular Resistance; Vasodilator Agents; Ventricular Function

Topics: Angina Pectoris; Humans; Piperidines

Topics: Angina Pectoris; Benzophenones; Coronary Disease; Humans; Myocardial Infarction; Piperidines; Pyrazoles; Quaternary Ammonium Compounds; Sulfonic Acids