ELECTROCARDIOGRAPHIC EVALUATION OF THE AN TIISCHEMIC EFFECTS OF VERAPAMIL DURING ANGIOPLASTY

The anti-ischemic and cardioprotective effects of various angina drugs have been evaluated during angioplasty. This special situation of tra nsitory regional ischemia was used to test verapamil given by intra-co ronary injection in 15 patients undergoing balloon dilatation of the l eft anterior descending artery, suffering from stable angina and with normal left ventricular kinetics. Each patient serving as his own cont rol, parameters indicating oxygen consumption and clinical and electro cardiographic (ST segment changes) markers were measured during two su ccessive inflations. Continuous monitoring of comparative variations b etween a first inflation without treatment and a second inflation afte r intra-coronary administration of 1 mg of verapamil revealed, followi ng 60 seconds of ischemia, the absence of any change in heart rate, a moderate fall in mean blood pressure (101.7 as against 96.8 mmHg, p = 0.033) and a notable 60 % reduction in the amplitude of maximal ST dep ression (5.07 +/- 3.08 mm as against 2.07 +/- 1.44 mm, p = 0.0002). Th ese results confirm the anti-ischemic properties of verapamil, the act ion of which is based upon an indirect peripheral vasodilator model bu t also on a probable direct cardioprotective effect on anoxic myocardi al regions.