Comparison of AQ-A 39 with propanolol and placebo in ischaemic heart disease.

In a randomized, controlled study 10 male patients with angiographically confirmed ischaemic heart disease received AQ-A 39 (falipamil), a heart rate reducing agent in a single intravenous dose (2 mg kg-1) in comparison to propranolol (0.1 mg kg-1). Both drugs reduced heart rate in supine position slightly. The rise of heart rate induced by orthostasis was diminished by AQ-A 39 to 4 +/- 2 beats min-1 and by propranolol 9 +/- 2 beats min-1. After submaximal exercise heart rate during placebo was 129 +/- 3, during AQ-A 39 113 +/- 3 and during propranolol 103 +/- beats min-1. Systolic arterial pressure decreased by propranolol only. The double product obtained by placebo was 231 +/- 10 while it was for 194 +/- 9 after AQ-A 39 and 158 +/- 6 mmHg min-1 after propranolol, respectively. Both substances increased exercise time as compared to placebo. Furthermore, AQ-A 39 increased noradrenaline plasma levels in the upright position and after submaximal exercise compared to the values obtained following placebo. The dose of isoproterenol necessary to induce an increase of heart rate by 20 beats min-1 was after AQ-A 39 4.2 times greater and following propranolol 9.2 times greater than during placebo. The results suggest that AQ-A 39 will be useful in the short term management of patients with ischaemic heart disease.