Lidoflazinin Angina Pektoris Tedavisinde Değeri

Year 1976, Volume: 29 Issue: 3 , 599 - 612 , 30.09.1976

Abdülkadir Dökmeci

https://izlik.org/JA27NX26KE

Abstract

ackground: Although structural causes of angina pectoris are well defined, the precise physiological triggers of pain episodes remain less clear. Transient myocardial ischemia from increased oxygen demand or decreased coronary flow underlies angina, and current treatments focus on symptom relief rather than reversing established atherosclerosis. Lidoflazine is widely used as an antianginal agent, yet its mechanism and clinical efficacy require further elucidation.

Objective: To evaluate the effects of lidoflazine on anginal pain, hemodynamic parameters (blood pressure, heart rate, and the rate–pressure product), and electrocardiographic changes at rest and during exercise in patients with stable angina pectoris.

Methods: Twenty-nine patients (mean age 52.9 years; 21 men, 7 women) underwent a three-week lidoflazine regimen (60 mg/day in week 1, 120 mg/day in week 2, 180 mg/day in week 3) over 32–58 days. Resting and post-exercise systolic blood pressure and heart rate were recorded during standardized bicycle ergometer testing (500 kpm/min for 5 minutes). Exercise-induced changes were expressed as percentage increases over baseline. Rest and exercise electrocardiograms were evaluated for ST-segment and T-wave alterations. Adverse effects were documented.

Results: Following treatment, 11 of 28 evaluable patients experienced a reduction or elimination of anginal episodes. Resting systolic blood pressure and heart rate decreased significantly (p < 0.001), with a concomitant reduction in the resting rate–pressure product (p < 0.01). However, lidoflazine did not attenuate the exercise-induced rise in blood pressure or the rate–pressure product; exercise heart rate increase was actually greater post-treatment (52.4% vs. 37.5%). Post-exercise ST-segment depression lessened in 13 patients, remained unchanged in 14, and worsened in one. No drug-related arrhythmias were observed. Two patients reported mild gastrointestinal and neurological side effects that resolved upon dose adjustment.

Conclusion: Lidoflazine significantly lowers resting blood pressure, heart rate, and myocardial oxygen demand but does not mitigate exercise-induced hemodynamic stress. Its partial relief of anginal pain and favorable safety profile support its adjunctive use, though it may be insufficient as monotherapy for exertional ischemia.

Keywords

Angina Pectoris , Lidoflazine , Hemodynamic Parameters , Exercise Testing , Electrocardiography

The Value of Lidoflazine in the Treatment of Angina Pectoris

https://izlik.org/JA27NX26KE

Abstract

Bu çalışmada angina pektoris ataklarının temelinde yatan geçici miyokard iskemisinin istirahat ve efor sırasında hemodinamik değişkenler üzerindeki etkileri ile lidoflazinin bu parametreler ve elektrokardiyografik bulgular üzerindeki rolü incelenmiştir.

Çalışmanın amacı, lidoflazinin anginal ağrıya, kan basıncına, kalp hızına, basınç × hız (rate–pressure product) değerine ve EKG’de ST-segment depresyonuna etkilerini değerlendirmektir.

Yirmi dokuz stabil angina pektoris hastasına üç hafta boyunca artan dozlarda (60 mg, 120 mg, 180 mg/gün) lidoflazin verildi. İstirahat ve bisiklet ergometre testi sonrasında ölçülen sistolik kan basıncı ve nabız atım hızı kayıt edildi; artışlar başlangıç değerine göre yüzde oranlarla belirlendi. EKG’lerde ST ve T dalgası değişiklikleri değerlendirildi.

Tedavi sonrası 28 hastanın 11’inde anginal atak sıklığı ve şiddetinde azalma görüldü. İstirahatte kan basıncı ve kalp hızı anlamlı düzeyde düştü (p < 0.001), resting rate–pressure product da azaldı (p < 0.01). Efor kaynaklı kan basıncı artışı değişmezken, efor nabız artışı tedavi öncesine kıyasla yükseldi (%37.5 → %52.4). Efor sonrası ST-depresyonu 13 hastada düzeldi, 14 hastada sabit kaldı, 1 hastada kötüleşti. İlaçla ilişkili ciddi aritmi saptanmadı; iki hastada doz düzenlemesiyle gerileyen hafif gastrointestinal ve nörolojik yan etkilere rastlandı.

Sonuç olarak lidoflazin istirahatte miyokard oksijen talebini azaltarak hemodinamik yükü hafifletirken efor sırasında oluşan artışı engelleyememektedir. Kısmi ağrı rahatlatıcı etkisi ve iyi tolere edilebilir güvenlik profili, ilacın tamamlayıcı tedavi olarak kullanılabileceğini göstermektedir.

Keywords

Lidoflazin , Angina Pektoris , Hemodinamik Parametreler , Egzersiz Testi , Elektrokardiyografi

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