Effects of Sustained Isometric Handgrip on Ventricular Systolic Time Intervals in Patients with Ischemic Heart Disease Inotropic State of the Left Ventricle during Treatment with Perhexiline Maleate and with Propranolol

• Published in: Japanese Heart Journal Vol. 18; no. 4; pp. 434 - 446
• Main Authors: CAPONNETTO, Salvatore, IANNETTI, Mario, PASTORINI, Carlo, MASPERONE, Maria Augusta, PERUGINI, Paola, ORIANI, Giovannangelo
• Format: Journal Article
• Language: English
• Published: Japan International Heart Journal Association 01.01.1977
• Subjects: Aged; Angina; Beta-blocking agent; Blood Pressure; Coronary Disease - drug therapy; Coronary Disease - physiopathology; Electrocardiography; Female; Hand; Heart Rate; Humans; Isometric Contraction; Isometric exercise; Left ventricular function; Male; Middle Aged; Perhexiline - analogs & derivatives; Perhexiline - therapeutic use; Physical Exertion; Piperidines - therapeutic use; Placebos; Polygraphic tracing; Propranolol - therapeutic use; Space life sciences; Triple product
• ISSN: 0021-4868; 1348-673X
• DOI: 10.1536/ihj.18.434

It was found from our previous studies that patients suffering from ischemic heart disease with angina, showed either one of the patterns of the left ventricular systolic time intervals on isometric handgrip exercise. Patients in class I or II NYHA showed a shortened pre-ejection period corrected for heart rate (PEPI), and a prolonged ejection period corrected for heart rate (LVETI) together with a decrease of the PEP/ LVET ratio. This response is normal, because it has also been found in normal subjects. The patients in class III or IV NYHA showed a prolongation of PEPI, shortening of LVETI and an increase of the PEP/LVET ratio. This response is abnormal, because it occurs in patients with impaired cardiac performance and in ischemic ones with widespread asynergic areas. Our aim here is to study the response of these 2 groups of patients treated for a 4-week period with perhexiline maleate. This new drug is chiefly used as anti-anginal drug, though it also has anti-arrhythmic properties. The results show that the response of the left ventricle to isometric handgrip exercise in class I or II patients following perhexiline maleate treatment, is almost normal, thus confirming that the drug has no side effects on the cardiodynamics checked by the left ventricular systolic time intervals. The responses of class III or IV patients after perhexiline maleate become normal. This shows that the drug acts by removing the contractile dysfunction. It can reasonably be assumed that this takes place following the elimination of the ischemia induced dyssynergic areas. The effect of this drug has also been evaluated from a clinical point of view. A marked decrease in the frequency of anginal crises and the consequential reduction in the consumption of trinitroglycerin pills during perhexiline maleate treatment could thus be observed.