HEMODYNAMIC-EFFECTS OF INTRAVENOUS ELGODIPINE IN CORONARY-ARTERY DISEASE DURING REST AND EXERCISE, AND BASIC PHARMACOKINETIC PARAMETERS

Using an echo-Doppler method (Quantascope), the hemodynamic profile of the calcium channel antagonist elgodipine (64 mu g/kg, iv) was invest igated in 22 patients with angina pectoris at rest and during exercise . A placebo control was used. At rest, elgodipine significantly decrea sed systemic vascular resistance as well as systolic and diastolic blo od pressure, while increasing cardiac output and stroke volume. During supine bicycle exercise at constant workload, elgodipine significantl y increased cardiac output and stroke volume, and decreased the rate-p ressure-product (double product); the exercise systolic blood pressure was decreased without change in the diastolic component. Elgodipine s ignificantly reduced the incidence and severity (self-rated pain score ) of exercise-induced anginal symptoms. Heart rate was not affected by elgodipine, either at rest or during exercise. In particular, no nega tive inotropy could be inferred from the echo-Doppler data. In the elg odipine plasma concentration profile (HPLC), three phases of eliminati on with half-life times of less than 1 hour, between 3 and 7 hours, an d between 10 and 24 hours may be distinguished, indicating a ''shallow '' and a ''deep'' compartment. The hemodynamic data indicate an interm ediate pharmacodynamic profile of elgodipine, lying between that of ot her dihydropyridines and that of compounds such as verapamil or diltia zem.