Summary
The effect of a single dose of cibenzoline ((diphenyl 2,2 cyclopropyl) -2 imidazoline, Cipralan), a new compound with antiarrhythmic properties was studied in 14 patients undergoing routine heart catheterization for suspected coronary artery disease. The effect of the drug on dP/dt, Vmax TP, Vce, negative dP/dt, heart rate (HR), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), cardiac index (CI) and systemic vascular resistance (SVR) was measured before and after drug administration. A significant decrease in left ventricular isometric contraction parameters was manifested immediately after injection, with its maximal effect 2 to 5 min after injection. An increase in HR, a decrease in LVSP, a decrease in CI and an increase in SVR were observed; LVEDP was not significantly altered, nor was negative dP/dt. The effect of the drug on Vmax TP and LVEDP was also examined during two atrial pacing stress tests (APST) done before and 10 to 20 min after drug administration. Although the negative inotropic action of the drug was apparent during the second APST, the effect was less pronounced at higher paced heart rates. No difference in the two tests was found between the maximal paced heart rate, nor was there a difference in the angina threshold. Finally the plasma level of the drug and the changes in certain parameters were compared. A positive correlation was found between the plasma level and dP/dt, Vmax TP and cardiac index.
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References
Bigger JT, Hoffman BF (1980) Antiarrhythmic drugs. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. MacMillan, New York, p 761–792
Brower RW, Remme WJ, ten Katen HJ, van den Brand M (1977) Quantification of the atrial pacing stress test: normal values and limits between normal and abnormal for coronary artery disease in man. Comp Cardiol (Rotterdam): 591–599
Canal M, Flouvat B, Tremblay D, Dufour A (1983) Pharmacokinetics in man of a new antiarrhythmic drug: Cibenzoline. Eur J Clin Pharmacol 24: 509–515
Desouter P, Dufour A, Aymard MF, Haiat R (1983) Etude pharmacocinétique d'un nouvel antiarrhythmique la Cibenzoline à la phase aiguë d'un infarctus myocardique. Corrélations thérapeutiques. Thérapie 38: 237–245
Dreifus LS, Morganroth J (1980) Antiarrhythmic agents. In: Dreifus LS, Brest AN (eds) Clinical application of cardiovascular drugs. Nijhoff, The Hague Boston London, p 1–45
Lucchesi BR (1977) Antiarrhythmic drugs. In: Antonaccio MJ (ed) Cardiovascular pharmacology. Raven Press, New York, 269–335
Meester GT, Bernard N, Zeelenberg C, Brower RW, Hugenholtz PG (1975) A computer system for real time analysis of cardiac catheterization data. Catheterization Cardiovasc Diagnosis 1: 113–132
Millar JS, Vaughan-Williams EM (1982) Effects on rabbit nodal, atrial, ventricular and Purkinje cell potentials of a new antiarrhythmic drug, cibenzoline, which protects against action potential shortening in hypoxia. Br J Pharmacol 75: 469–478
Snedecor GW, Cochran WG (1967) Statistical methods (6th edn). Iowa State University Press, Ames, Iowa
Stenson RE, Crouse L, Henry WL, Harrison DC (1968) A time shared digital computer system for on line analysis of cardiac catheterization data. Comp Biomed Res 1: 605–614
Thebaut JF, Achard F, De Langenhagen B (1980) Etude electrophysiologique chez l'homme d'un nouvel antiarythmique, la cibenzoline, dans le syndrome de Wolff-Parkinson-White. Inf Cardiol 4: 393–402
Thizy JF, Jandot V, Andre-Fouet X, Viallet M, Pont M (1981) Etude electrophysiologique de l'up 339.01 chez l'homme. Lyon Med 245: 119–122
Verdouw PD, Remme WJ, Hugenholtz PG (1977) Cardiovascular and antiarrhythmic effects of aprindine (AC 1802) during partial occlusion of a coronary artery in the pig. Cardiovasc Res 11: 317–323
Verdouw PD, Deckers JW, Conard GJ (1979) Antiarrhythmic and hemodynamic actions of flecainide acetate (R-818) in the ischemic percine heart. J Cardiovasc Pharmacol 1: 473–486
Verdouw PD, Hartog JM, Scheffer MG, Van Bremen RM, Dufour A (1982) The effects of cibenzoline, an imidazoline derivative with antiarrhythmic properties, on systemic hemodynamics and regional myocardial performance. Drug Dev Res 2: 519–532
Wagner JG (1976) Linear pharmacokinetic equations allowing direct calculation of many needed pharmacokinetic parameters from the coefficients and exponents of poly-exponential equation which have been fitted to the data. J Pharmacokinet Biopharm 4: 443–467
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van den Brand, M., Serruys, P., de Roon, Y. et al. Haemodynamic effects of intravenous cibenzoline in patients with coronary heart disease. Eur J Clin Pharmacol 26, 297–302 (1984). https://doi.org/10.1007/BF00548758
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DOI: https://doi.org/10.1007/BF00548758