Open AccessLong-Term Treatment With Perindopril Ameliorates Dobutamine-Induced Myocardial Ischemia in Patients With Coronary Artery Disease
Author(s) -
Tsuyoshi Morishita,
Masato Tsutsui,
Hiroaki Shimokawa,
Hiromi Tasaki,
Osamu Suda,
Kengo Kobayashi,
Masataka Horiuchi,
Haruhito Okuda,
Yujiro Tsuda,
Nobuyuki Yanagihara,
Yasuhide Nakashima
Publication year - 2002
Publication title -
japanese journal of pharmacology/japanese journal of pharmacology
Language(s) - English
Resource type - Journals
eISSN - 1347-3506
pISSN - 0021-5198
DOI - 10.1254/jjp.88.100
Subject(s) - perindopril , medicine , cardiology , coronary artery disease , dobutamine , bradykinin , ischemia , angiotensin converting enzyme , hemodynamics , blood pressure , receptor
The present study was designed to examine whether long-term blockade of angiotensin-converting enzyme (ACE) with perindopril ameliorates dobutamine-induced myocardial ischemia in patients with coronary artery disease (CAD). Twelve patients with proven CAD were randomly divided in two groups; one group received perindopril (8 mg/day, p.o.) for 3 months and another group served as a control. To evaluate anti-ischemic effects of perindopril, dobutamine stress echocardiography was performed before and 3 months after the treatment in a double-blind manner. Long-term treatment with perindopril significantly ameliorated the dobutamine-induced myocardial ischemia, as evaluated by time to the onset of symptoms, magnitude of electrocardiographic ST-segment changes, and left ventricular wall motion score (all P<0.05). The treatment significantly decreased serum ACE activities (P<0.01) and increased plasma bradykinin concentrations (P<0.05). The extent of reduction of left ventricular wall motion score by perindopril was closely correlated with that of inhibition of serum ACE activities (P<0.01) and with that of increase in plasma bradykinin concentrations (P<0.05). By contrast, no such beneficial changes were noted in the control group. These results provide the first evidence that long-term treatment with perindopril exerts anti-ischemic effects on the myocardial ischemia induced by increased myocardial oxygen demand in patients with CAD.